Virtual cavernoscopy: a novel diagnostic tool for use in the corpus cavernosal lumen in patients with erectile dysfunction

Izumi, Kazuyoshi; Kawanishi, Yasuo; Muguruma, H.; Kusuhara, Y.; Komori, Masatsugu; Yamanaka, Manabu D.; Yamamoto, Akira; Numata, Akira; Kishimoto, Tomoteru; Kanayama, Hiro‐omi

doi:10.1111/j.1464-410x.2010.10003.x

Cited by 9 publications

(8 citation statements)

References 12 publications

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“…For this scheme the newest data about venous drainage of the Penis was included. Izumi et al [13] described, that the cavernous vein, the most common drainage vein, originates from the coapted part where the right and left corpus cavernosum join together [13]. Specifically the cavernous veins flow out from proximal dorsal points at the furcation of the crus.…”

Section: Resultsmentioning

confidence: 99%

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CT Cavernoso Graphy and Penile Venous Leak

Herwig

2017

JOJUN

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Introduction:The aim of this work was to verify the value of CT-Cavernosography for penile venous leak diagnosis. Furthermore, we evaluated the effectiveness of pelvic vein embolisation with aethoxysclerol in aero-block technique for the treatment of impotence due to venous leakage in men using sildenafil for intercourse. The aim of this procedure was to reduce or eliminate the use of sildenafil.Material and methods: A total of 49 patients with veno-occlusive dysfunction, severe enough for the need of PDE5 inhibitors for vaginal penetration, underwent pelvic venoablation with aethoxysklerol. The mean patient age was 53.5 years. Venous leaks were identified by Color Doppler Ultrasound and CT Cavernosography after intra-cavernousal prostadil injection. Under local anesthesia a 5F-Angioport was inserted antegrade into the penile deep dorsal penile vein. Aethoxysklerol 3% as sclerosing agent was injected in air-block under Valsalva manoeuver. Success was defined as the ability to achieve vaginal insertion without the aid of any drugs, vasoactive injections, penile prosthesis, or vacuum device. Additionally, a pre-and post-therapeutical IIEF-5 score was performed.Results: At a 12 month follow-up 40 out of 49 patients (81.63%) reported to have erections sufficient for vaginal insertion without the use of any drug or additional device. 4 (8.16%) patients did not report any betterment. Mean IIEF-Score and IIEF-Score-Differences after intervention see Figure 1 & 2. No serious complications occurred. Conclusion:Our new pelvic venoablation technique using pre-operative Ct-cavernosography and aethoxysklerol in air-block technique was effective and minimally invasive. All patients were able to perform sexual intercourse without the previously used dosage of their PDE5 inhibitor. This new method may help in patients with contra-indications against PDE5 inhibitors, in patients who cannot afford the frequent usage of expansive oral medication or those who do not fully response to PDE5-inhibitors.

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Section: Resultsmentioning

confidence: 99%

“…Crural veins were observed in the dorsal part of the crus. Crural veins originated from the midpoint of the crus or at a more distal point [13].…”

Section: Resultsmentioning

confidence: 99%

CT Cavernoso Graphy and Penile Venous Leak

Herwig

2017

JOJUN

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“…The management of patients with vasculogenic erectile dysfunction has been revolutionized since the introduction of phosphodiesterase 5 inhibitors, which inhibit the degradation of cyclic guanosine monophosphate, resulting in increased blood flow to the corpora cavernosa. Failure of oral treatments for erectile dysfunction often leads to referrals for evaluation of penile blood flow, and although several imaging modalities have been used for this purpose (e.g., conventional angiography, computed tomography including “virtual cavernoscopy”), by far, the most commonly used modality is Doppler ultrasound [13–15]. Doppler ultrasound is usually performed following the intracavernosal injection of a stimulating substance such as prostaglandin E and allows evaluation of the hemodynamics of the cavernosal artery throughout the erectile process and the detection of vascular abnormalities such as arterial insufficiency, veno‐occlusive dysfunction, and venous leakage [16,17].…”

Section: Discussionmentioning

confidence: 99%

Association Between Penile Dynamic Contrast-Enhanced MRI-Derived Quantitative Parameters and Self-Reported Sexual Function in Patients with Newly Diagnosed Prostate Cancer

Vargas

Donati

Wibmer

et al. 2014

The Journal of Sexual Medicine

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Introduction The high incidence of prostate cancer, coupled with excellent prostate cancer control rates, has resulted in growing interest in nononcological survivorship issues such as sexual function. Multiparametric magnetic resonance imaging (MRI) is increasingly being performed for local staging of prostate cancer, and due to the close anatomical relationship to the prostate, penile enhancement is often depicted in prostate MRI. Aim To evaluate the associations between quantitative perfusion-related parameters derived from dynamic contrast-enhanced (DCE)-MRI of the penis and self-reported sexual function in patients with newly diagnosed prostate cancer. Methods This retrospective study included 50 patients who underwent DCE-MRI for prostate cancer staging before prostatectomy. The following perfusion-related parameters were calculated: volume transfer constant (Ktrans), rate constant (kep), extracellular-extravascular volume fraction (ve), contrast enhancement ratio (CER), area under the gadolinium curve after 180 seconds (AUC180), and slope of the time/signal intensity curve of the corpora cavernosa. Associations between perfusion-related parameters and self-reported sexual function were evaluated using the Wilcoxon Rank-Sum test. Main Outcome Measures Patient responses to the sexual function domain of the Prostate Quality of Life survey. Results Five of the six DCE-MRI parameters (Ktrans, ve, CER, AUC180, and slope) were significantly associated with the overall score from the sexual domain of the survey (P = 0.0020–0.0252). CER, AUC180, and slope were significantly associated with the answers to all six questions (P = 0.0020–0.0483), ve was significantly associated with the answers to five of six questions (P = 0.0036–0.1029), and Ktrans was significantly associated with the answers to three of six questions (P = 0.0252–0.1023). kep was not significantly associated with the overall survey score (P = 0.7665) or the answers to any individual questions (P = 0.4885–0.8073). Conclusion Penile DCE-MRI parameters were significantly associated with self-reported sexual function in patients with prostate cancer. These parameters are readily available when performing prostate MRI for staging and may be relevant to the management of patients considering prostate cancer therapies.

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“…At present, virtual endoscopy can be used not only in clinical diagnosis but also in the study of anatomical structure (72). After cavernosography, forty patients underwent 3D-CT examination, and the virtual endoscopic images of cavernous body were reconstructed according to 3D-CT data (73). Not only the cavernous septum can be observed, but also the blood flow signals of arterial inflow and venous outflow can be observed respectively.…”

Section: Computed Tomography Angiography (Cta)mentioning

confidence: 99%

Current approaches to the diagnosis of vascular erectile dysfunction

Ma¹,

Bian²,

Qin³

et al. 2020

Transl Androl Urol

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Vascular erectile dysfunction (ED) is closely related to cardiovascular events, and early diagnosis of vascular ED may be helpful to predict the occurrence of cardiovascular events and improve prognosis.At present, there are many approaches to diagnose ED, but each method has its advantages and limitations.This study retrospectively reviewed all available literature focusing on the diagnosis of vascular ED through a systematic PubMed and EMBASE search. According to the different application scenarios, the main methods for the diagnosis of vascular ED are divided into four categories. Intra-cavernous injection of vasoactive drugs is the earliest method used in the diagnosis of vascular ED and is a basic test. For the diagnosis of arterial ED, color duplex Doppler ultrasound, selective penile angiography, magnetic resonance imaging, and computed tomography are more commonly used. While for the diagnosis of venous ED, shear wave elastography, dynamic infusion cavernosometry and cavernosography are more accurate. Endo-peripheral arterial tonometry (PAT) has also been used to detect vascular endothelial function. Although various existing examinations are widely used for the evaluation of vascular ED, they still have some shortcomings, such as invasiveness, contingency, high false positive (negative) rate. New methods of long-term dynamic detection are needed.

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Virtual cavernoscopy: a novel diagnostic tool for use in the corpus cavernosal lumen in patients with erectile dysfunction

Cited by 9 publications

References 12 publications

CT Cavernoso Graphy and Penile Venous Leak

CT Cavernoso Graphy and Penile Venous Leak

Association Between Penile Dynamic Contrast-Enhanced MRI-Derived Quantitative Parameters and Self-Reported Sexual Function in Patients with Newly Diagnosed Prostate Cancer

Current approaches to the diagnosis of vascular erectile dysfunction

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