Penile duplex pharmaco-ultrasonography revisited: revalidation of the parameters of the cavernous arterial response.
OBJECTIVE
We revalidate parameters of the cavernous arterial response (peak systolic blood flow velocity) and acceleration time using penile duplex pharmaco-ultrasonography.


METHODS
Blood flow velocity in the cavernous artery following pharmaco-stimulation was determined with duplex ultrasonography in 106 patients with erectile dysfunction. Intima media thickness of the common carotid artery, a valid index for atherosclerosis and clinical diagnosis based on a comprehensive evaluation were used as references. The clinical diagnosis was used to determine cutoff values. For the statistical analysis, Pearson correlation and ROC curves were used.


RESULTS
When correlating peak systolic velocity and acceleration time to intima media thickness, acceleration time (r = 0.51, p <0.01) was the most valid parameter to detect cavernous atherosclerotic pathology (peak systolic velocity r = -0.18, p = 0.12). This finding was confirmed by a comparison of both parameters to the clinical diagnosis. AUC was 0.59, 95% CI 0.49-0.69 for peak systolic velocity and 0.72 (95% CI 0.62-0.80 for acceleration time). The cutoff point for acceleration time to discriminate between atherosclerotic and nonatherosclerotic erectile dysfunction was determined at acceleration time 100 milliseconds or greater. Sensitivity was 66% and specificity was 71%.


CONCLUSIONS
The results of this study show that acceleration time has more power than peak systolic velocity to diagnose atherosclerotic erectile dysfunction.
Speel
T G W
TG
Department of Urology, University Medical Center, Nijmegen, The Netherlands.
van Langen
H
H
Wijkstra
H
H
Meuleman
E J H
EJ
D000317:Adrenergic alpha-Antagonists / Q000494:pharmacology; D000328:Adult; D000368:Aged; D001158:Arteries / Q000000981:diagnostic imaging / Q000187:drug effects; D001161:Arteriosclerosis / Q000150:complications / Q000000981:diagnostic imaging; D001783:Blood Flow Velocity / Q000187:drug effects*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D007172:Erectile Dysfunction / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D018783:Impotence, Vasculogenic / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010208:Papaverine / Q000494:pharmacology; D010413:Penis / Q000098:blood supply* / Q000000981:diagnostic imaging; D010646:Phentolamine / Q000494:pharmacology; D017539:Tunica Intima / Q000000981:diagnostic imaging; D018616:Ultrasonography, Doppler, Duplex; D014665:Vasodilator Agents / Q000494:pharmacology
D000317:Adrenergic alpha-Antagonists; D014665:Vasodilator Agents; D010208:Papaverine; D010646:Phentolamine