Evaluation of penile cavernosal artery intima-media thickness in patients with erectile dysfunction. A new parameter in the diagnosis of vascular erectile dysfunction. Our experience on 59 cases.
OBJECTIVE
A precise characterization of erectile dysfunction (ED) of vascular origin has not yet been achieved, although cavernous peak systolic velocity (PSV) is generally considered a major parameter. Nevertheless the penile dynamic color Doppler is invasive and linked to several complications. The intima-media thicknesses (IMT) of cavernosal artery would add to the predictive value of vasculogenic ED risk and outcomes. We also hypothesized the existence of a correlation between IMT cavernosal artery and IMT carotid arteries. This study seeks to evaluate these hypotheses with our experience, investigating the predictive accuracy of carotid and cavernosal Doppler ultrasound findings for discriminating patients with vasculogenic ED.


METHODS
A total of 59 subjects (32 vasculogenic ED patients - group A - and 27 no vasculogenic ED patients - group B) were evaluated in our andrological center from September 2012 to June 2013 and enrolled in the study. All subjects underwent medical history, erectile function domain of the International Index of Erectile Function, physical examination, routine and sex hormone blood tests, and high resolution dynamic color Doppler ultrasound evaluation of carotid and penile districts and valuation of IMT in both districts.


RESULTS
The values of cavernosal artery IMT in group A were higher than in group B (0,28 ± 0,06 mm vs 0,17 ± 0,07 mm). Even the values of carotid artery IMT in vasculogenic ED group were higher than in no vasculogenic ED group (0,74 ± 0,14 mm vs 0,59 ± 0,11 mm). The cavernosal IMT showed a moderate (r = 0.61) positive linear correlation (p < 0.001) with the carotid artery IMT.


CONCLUSIONS
An increased cavernous IMT might predict ED of vascular origin with more accuracy than PSV and could be a sensitive predictor also for systemic atherosclerosis at an earlier phase.
Department of Urology, University Federico II of Naples. dprezioso@libero.it.
Domenico
D
Prezioso
Fabrizio
F
Iacono
Umberto
U
Russo
Giuseppe
G
Romeo
Antonio
A
Ruffo
Nicola
N
Russo
Ester
E
Illiano
D000328:Adult; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging; D007172:Erectile Dysfunction / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D006439:Hemodynamics; D006801:Humans; D018783:Impotence, Vasculogenic / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010413:Penis / Q000098:blood supply* / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology*; D018615:Ultrasonography, Doppler, Color