[Echo-Doppler duplex combined with intracavernous injection of prostaglandin E1 in the diagnosis of impotence].
Sixty-two patients that had consulted for impotence were evaluated by intracavernal injection of prostaglandin E1 and duplex echo-Doppler. The internal diameter and the mean flow of the cavernosal arteries were determined by echo-Doppler in the flaccid state. Thereafter 20 micrograms of PGE 1 was injected intracavernously and the erectile response was evaluated clinically after 5 to 15 minutes. Another Doppler evaluation was performed during tumescence to study the changes of the internal diameter and the mean flow increase of the cavernal arteries. Twenty-nine patients (46.7%) achieved normal erection after intracavernal PGE 1 and the Doppler study was normal in all but 2 patients (3.2%). The remaining 33 patients (53.1%) failed to achieve normal erection following intracavernal injection of PGE 1. The Doppler study, however, was normal in 7 of these patients (11.2%), which indicates venous leak to be the underlying cause of impotence. There were minor complications (19.3%) presented a small hematoma at the site of injection and 12.9% referred moderate pain at the time of injection) and no patient has a sustained erection for more than 3 hours. The hemodynamic mechanisms and the current concepts relative to the neurologic aspects of erection are discussed. We believe duplex echo-Doppler combined with intracavernal PGE 1 to be a very reliable method in the diagnosis of impotence of a vascular origin. It can distinguish those patients that cannot achieve erection following intracavernal PGE 1 with a normal arterial tree whose impotence can be ascribed to venous leak.
Moncada Iribarren
I
I
Servicio de Urología, Hospital General Gregorio Marañón, Madrid, España.
Concejo
J
J
Escribano Patiño
G
G
Verdú Tartajo
F
F
Díez Cordero
J M
JM
Herranz Amo
F
F
Jara Rascon
J
J
Basquero González
B
B
Martin Martínez
J C
JC
Hernández Fernández
C
C
D000328:Adult; D000368:Aged; D000527:Alprostadil / Q000008:administration & dosage; D007172:Erectile Dysfunction / Q000175:diagnosis*; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography / Q000379:methods
D000527:Alprostadil
Eco-Doppler duplex asociado a inyección intracavernosa de prostaglandina E1 en el diagnóstico de la impotencia.