(523) Use of Penile Doppler in the Management of Erectile Dysfunction: A Survey on Trends and Contemporary Practice

Abstract Introduction Erectile dysfunction is a common condition with variable aetiology and risk factors associated with chronic health disease (vascular, hormonal, neurological, psychological). Second-line tests such as Penile doppler ultrasound are recommended by EAU and AUA in specific circumstances. Despite this it’s use and interpretation in practice is varied, with differences in guideline indications and a lack of standardised metric for haemodynamic parameters making interpretation difficult. Whilst penile doppler has been shown to be of benefit in specific situations, it’s utilisation in clinical practice can be varied. Objective To assess the contemporary trends and use of penile doppler in the management of erectile dysfunction Methods An online electronic questionnaire was distributed to practicing Urologists. Questions explored demographics and practice setting, with further questions looking specifically at Penile doppler usage, it’s interpretation and clinical impact. Results were analysed descriptively (qualitative and quantitative). Results 57 Urologists completed the survey with the majority of respondents based in the UK (89.5%). 88% of respondents were Urology Consultants with 21 (39%) Andrology sub-specialists. 83% of consultants reported managing erectile dysfunction in practice. 45.6% of respondents worked in a unit where penile doppler was available, however, actual penile doppler use was reported at 33%. The most common cited indications included history of pelvic/perineal trauma (51.8%), men under 35 (37.5%) and suspected vasculogenic ED (39.3%) in line with AUA and EAU recommendations. Other cited indications included Psychogenic ED (22.2%), complex psychological disorders (14.8%) and Medicolegal reasons (24.1%). Both PSV and EDV cut-off values for arterial insufficiency and venous leak respectively were variable (PSV between 25-35cm/s, <25cm/s in 52.3%, EDV between 5 and 7cm/s, 5cm/s in 67.4%) For those using penile doppler 40% of respondents felt penile doppler did not change management, with a further third reporting it altered management rarely (28.8%). Only 40.4% reported penile doppler was useful in the overall diagnosis and management of ED. Conclusions Penile doppler does not appear routine in current practice with only 33% using penile doppler in practice (and only 63% of practicing Andrologists using this). Common indications for its use in clinical practice appear in line with EAU and AUA recommendations. Variations in haemodynamic parameters remain a challenge in the standardised interpretation of this test. Despite its usage there remains mixed opinion as to its utility in the overall diagnosis and management of ED with only 43.4% of respondents finding penile doppler useful and 40% of respondents reporting it did not alter management. Disclosure No