title: The use of intracavernous injection and audiovisual sexual stimulation during real-time pharmacopenile doppler ultrasonography in vasculogenic erectile dysfunction.
abstract: BACKGROUND
  The objective of this study was to explore the role of intracavernous injection (ICI) and audiovisual sexual stimulation (AVSS) during real-time pharmacopenile Doppler ultrasonography (PDDU) in vasculogenic subtypes of erectile dysfunction.
  
  
  METHODS
  A total of 200 consecutive men with erectile dysfunction (ED) were enrolled. Each patient received 2 sessions of real-time PDDU. Session A was performed under ICI alone. Session B was performed under ICI plus AVSS. The interval between sessions was 7 days. Penile vascular parameters, including peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index, were monitored 5, 10 and 20 min after the start of the test. Patients were asked to describe the level of sexual arousal generated by choosing one of the pre-set answers.
  
  
  RESULTS
  In veno-occlusive ED, during session A, EDV at 10 min was significantly greater than at 5 and 20 min (p < 0.05). During session B, there was a significant difference regarding PSV in arteriogenic ED (p < 0.05). Mixed vasculogenic ED showed significant differences in PSV levels during session B, and EDV at 5 min was greater than at 10 and 20 min (p < 0.05). PDDU under ICI alone diagnosed 34 (17%), 35 (17.5%), 31 (15.5%) and 100 (50%) cases of arteriogenic, veno-occlusive, mixed vasculogenic and nonvasculogenic ED, respectively. The combination of ICI plus AVSS diagnosed 27 (13.5%), 44 (22%), 7 (3.5%) and 122 (60.7%) cases, respectively.
  
  
  CONCLUSIONS
  Adding AVSS during PDDU improves the recording of physiologic erectile response and may help the physician to accurately evaluate the cause of ED.
authors.affiliation: Department of Urology, The Third Xiangya Hospital of Central South University, Changsha, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Tang
authors.forename: Yuxin
authors.initials: Y
authors.lastname: Tang
authors.forename: Yingbo
authors.initials: Y
authors.lastname: Dai
authors.forename: Li
authors.initials: L
authors.lastname: Lu
authors.forename: Xianzhen
authors.initials: X
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000527:Alprostadil / Q000008:administration & dosage; D000704:Analysis of Variance; D001296:Audiovisual Aids; D001783:Blood Flow Velocity; D016009:Chi-Square Distribution; D004882:Erotica; D006801:Humans; D018783:Impotence, Vasculogenic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D010413:Penis / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D010775:Photic Stimulation; D011237:Predictive Value of Tests; D012039:Regional Blood Flow; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D018617:Ultrasonography, Doppler, Pulsed; D014655:Vascular Resistance; D055815:Young Adult
chemical_list: D000527:Alprostadil