Baseline Penile Ultrasound and Color Doppler Parameters – A Comparison Between Psychogenic and Vasculogenic Erectile Dysfunction Patients

Background and Objectives: There are many causes of erectile dysfunction (ED) like congenital anomalies, neurological, endocrinal, pharmacological, psychological, pathological or hemodynamic. Penile doppler ultrasound provides real-time evaluation of cavernosal vascular flow dynamics. Purpose of our study was to evaluate and compare the baseline penile ultrasound and color doppler vascular parameters in patients of ED to see if there was any significant difference between patients of psychogenic and vasculogenic ED (diagnosed on post Papaverine injection color doppler) without the use of intracavernosal Papaverine injection. To best of our knowledge such detailed comparison of baseline penile ultrasound and doppler parameters have not been published in literature. Methods: We have prospectively studied 32 patients of ED who underwent ultrasound, and color doppler pre-and post-papaverine intracavernosal injection. Baseline pre papaverine diameters of right and left cavernosal arteries were measured on grey scale ultrasound. Peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) of right and left cavernosal arteries were measured on color doppler before and after injecting intracavernosal papaverine injection. Patients were divided into normal study group (psychogenic ED), arterial insufficiency and venous leakage groups (vasculogenic ED) on the basis of post papaverine color doppler findings. Results: Eighteen patients showed normal study, 11 showed arterial insufficiency and 3 patients had venous leakage on post Papaverine injection color doppler. When base line prepapaverine vascular diameters and color doppler parameters were compared statistically, no significant difference was detected between and within these study groups. We have also compared Ed duration and IIEF scores among various study groups and found statistically significant difference between and within the groups. Conclusion: Use of a vasoactive agent like Papaverine with color Doppler is must to diagnose the vasculogenic ED.