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Categorization of erectile dysfunction based on the penile Colour Duplex Doppler Ultrasound

Categorization of erectile dysfunction based on the penile Colour Duplex Doppler Ultrasound

Objectives: Present study is performed to: 1) identify a vasculogenic ED, 2) differentiate between artereogenic, venogenic and combined ED, 3) to differentiate between the vasculogenic and psychogenic ED.

Methods: This is a hospital based study and the cohort was chosen from a group of 15,357 patients who sought treatment for sexual problems at Dr. Promodu’s Institute of Sexual and Marital Health Pvt. Ltd between February 2006 and January 2015. Through evaluations based on case history, clinical interview, physical examination, laboratory investigations and imaging procedures, ED was diagnosed in 8690 patients. Out of this, 2334 patients had undergone CDDU after taking vasoactive intracavernosal injection. Measurements were taken before and after the injection according to the study protocol.

Results: Based on the sonological parameters, ED was classified as arteriogenic ED – 72 (3.08%), venogenic ED – 606 (25.96%), mixed or combined ED – 75 (3.21%) and psychogenic ED – 529 (22.66%). There were 1052 (45.07%) patients with sonologically normal parameters. All the artereogenic cases had consistently low peak systoloic velocity of less than 25 cm/second, venogenic cases had high end diastolic velocity >5 cm/second and a resistive index of less than 0.75. In the mixed category, both arterial and venous dysfunctions were identified. Patients with psychogenic ED had a consistently normal PSV, fluctuating EDV, RI and erection grade.

Conclusion: CDDU is an effective, valuable and minimally invasive tool in the diagnosis and categorization of ED and the procedure will enable the clinician to plan the management strategy based on the findings