Gambaran Priapism pada USG Doppler

Priapism is a penile erection that lasts 4 hours or longer and is not associated with sexual activity. Identifcation of priapism is important because it requires treatment in time as soon as possible, especially for the low-?ow priapism/ischemic subgroups. Handling too late may lead to persisting erectile dysfunction as a result of irreversible corporal fbrosis. Therefore, the accurate radiology diagnosis is required to get adequate treatment. Penile Doppler ultrasound is the frst examination to distinguish the hemodynamic abnormalities in the penis of the in?ow and out?ow vessels.Some of the parameters used to measure penile arterial blood ?ow is peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI). Among the index, PSV is the most frequently used parameters. Priapism is classifed into ischemic and non-ischemic. At low ?ow ischemic priapism, venous out?ow is not visible on cavernosography and pulsation was not palpable. In ischemic priapism, Doppler ultrasound is useful for the identifcation of arterial ?ow cavernosal (no ?ow is suspected as cavernosal infarction), identifcation of variants of ischemic priapism that there is still high ?ow (often > 1-2 m/s) with high resistance (i.e non-perfusing). At low ?ow priapism there is a stasis of blood in the corpora cavernosa resulting in low pO2 and higher pCO2. The pH of the corporeal blood drops below 7.0 (acidosis). Erection then becomes painful and may progress to irreversible corporal fbrosis. Pain arising from tissue hypoxia and acidosis. It required immediate intervention therapy with irrigation and aspiration of corporal blood of150 - 200 ml. On color-?ow duplex sonography, non-ischemic high-?ow priapism shows high arterial in?ow and venous out?ow cavernosography showed normal. pH rises above 7.0. Color-?ow duplex sonography is a non-invasive examination compared to cavernosography.