[Exploration of the deep dorsal vein of the penis using pulsed Doppler ultrasonography. Preliminary study].
OBJECTIVE
This was an open preliminary study of 36 unselected men suffering from erectile dysfunction (DE) for the evaluation of the deep dorsal vein of the penis (VDP) by duplex scan (EDP). All men had an intravenous injection (IIC) with a vaso active agent: alprostadil (Edex) (n = 24), a mixture of papaverine ifenprodyl tartrate (Vadilex) (n = 4) or papaverine, ifenprodyl tartrate and alprostadil (n = 7). The deep dorsal vein was evaluated, with a 13 mHz mechanical probe 5 and 10 minutes after the injection, during visual sexual stimulation (SSV) carried on for 10 mn, and 3 mn after having stopped SSV. The influence of deep breathing and contraction of the ischio and bulbo-cavernous muscles was recorded at each of the periods.


RESULTS
The deep dorsal vein was identified in all cases. After pharmacological stimulation flow was present in 61% of the cases, with a statistically significant difference between alprostadil (80%) and both mixtures (20%). The addition of sexual stimulation caused flow to disappear in 64% of the cases (91% for the mixture and 44% for alprostadil). There was a range of variation under breathing and muscular contraction which deserves further evaluation.


CONCLUSIONS
1) The deep dorsal vein is easily studied under duplex scan and should be part of the routine examination of the vascular component of erection during erectile dysfunction. 2) The vein is subjected to modification of flow after intracavernous injection and sexual stimulation which varies with the agent injected and the clinical condition of the patients. 3) Absent flow early after injection seems to be predictive of the possibility of a prolonged erection.
Virag
R
R
Centre d'Exploration et Traitement de l'Impuissance, Paris.
Sussman
H
H
D000328:Adult; D000368:Aged; D000527:Alprostadil / Q000627:therapeutic use; D007172:Erectile Dysfunction / Q000000981:diagnostic imaging* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000098:blood supply*; D010880:Piperidines / Q000627:therapeutic use; D018617:Ultrasonography, Doppler, Pulsed; D014665:Vasodilator Agents / Q000627:therapeutic use; D014680:Veins / Q000000981:diagnostic imaging
D010880:Piperidines; D014665:Vasodilator Agents; D000527:Alprostadil; C010739:ifenprodil