madman
Super Moderator
Background: The method used in the first assessment of patients with veno-occlusive erectile dysfunction (ED) is penile color Doppler ultrasonography (PCDU). However, cavernosography performed following intracavernosal pharmacostimulation is accepted as a more precise method for showing venous leakage.
Aims: The objectives of this study were to compare results obtained from patients undergoing PCDU, and those undergoing cavernosography, and to investigate the diagnostic value of PCDU in the diagnosis.
Methods: A total of 133 patients who presented at the urology clinic due to ED have veno-occlusive dysfunction (VOD) detected as a result of PCDU and underwent cavernosography for further assessment when scheduled for penile embolization. The results obtained were retrospectively evaluated.
Results: The mean age of 133 patients with VOD identified as a result of PCDU was 48.7 ± 11.2 years. In cavernosography performed after PCDU, venous leakage was detected in 127 patients (95.49%), while no leakage was found in six patients (4.51%). Bilateral venous leakage was found in 91.34% (n:116), right venous leakage in 5.51% (n:7), and left venous leakage in 3.15% (n:4) of the patients with venous leakage.
Conclusion: Evaluating the cavernosography results, PCDU alone is often sufficient to diagnose veno‑occlusive ED. Cavernosography is a more invasive diagnostic method compared to PCDU that is adequate in cases where venous surgery or embolization is not considered, and cavernosography is not recommended in these patients.
Introduction
A compatible interaction among vascular, neurological, hormonal, and psychological systems is necessary for healthy sexual function in men. The first essential event for male sexual activity is the occurrence and continuity of penile erection.[1] Erectile dysfunction (ED) is defined as the inability to obtain and maintain a sufficient erection for satisfactory sexual performance.[2] The etiology of ED has been mainly classified as organic, psychogenic, and mixed.[3] Organic-origin ED is divided into six subgroups: neurogenic, hormonal, vascular, anatomic, trauma-related, and drug-related and accounts for 80% of all causes of ED.[4-7] Vascular-origin ED is the major cause of organic-origin EDs and endothelial dysfunction is the most important physiopathology. Vascular-origin EDs are evaluated as arterial insufficiency and veno‑occlusive dysfunction (VOD). The veno-occlusive mechanism, which is one of the most important stages of penile tumescence, depends on the balance between the smooth muscle and connective tissue in the corpus cavernosum.[8] Penile color doppler ultrasonography (PCDU) provides insight into the arterial and venous hemodynamic condition of the penis,[9] and this is the first step of the evaluation of vascular pathologies in patients with ED. In patients suspected to have VOD with PCDU, dynamic infusion cavernosometry and cavernosography performed following intracavernosal pharmaco-stimulation are accepted as effective methods in showing venous leakage precisely.[10] Although combined use of these two methods raises the probability of diagnosis, both methods can also be used alone. The objective of this study was to investigate the sufficiency of PCDU and the additional contribution of cavernosography to the diagnosis of ED due to VOD.
Conclusion
In our study, according to the results obtained from cavernosography, the diagnosis was correctly established in more than 95% of the patients who were found to have VOD with PCDU. This result indicates that PCDU is highly sufficient in the diagnosis of veno‑occlusive ED. Cavernosography is a more invasive diagnostic method than PCDU. PCDU is recommended in cases where venous surgery or embolization is not considered, whereas cavernosography is not recommended for these patients.
Aims: The objectives of this study were to compare results obtained from patients undergoing PCDU, and those undergoing cavernosography, and to investigate the diagnostic value of PCDU in the diagnosis.
Methods: A total of 133 patients who presented at the urology clinic due to ED have veno-occlusive dysfunction (VOD) detected as a result of PCDU and underwent cavernosography for further assessment when scheduled for penile embolization. The results obtained were retrospectively evaluated.
Results: The mean age of 133 patients with VOD identified as a result of PCDU was 48.7 ± 11.2 years. In cavernosography performed after PCDU, venous leakage was detected in 127 patients (95.49%), while no leakage was found in six patients (4.51%). Bilateral venous leakage was found in 91.34% (n:116), right venous leakage in 5.51% (n:7), and left venous leakage in 3.15% (n:4) of the patients with venous leakage.
Conclusion: Evaluating the cavernosography results, PCDU alone is often sufficient to diagnose veno‑occlusive ED. Cavernosography is a more invasive diagnostic method compared to PCDU that is adequate in cases where venous surgery or embolization is not considered, and cavernosography is not recommended in these patients.
Introduction
A compatible interaction among vascular, neurological, hormonal, and psychological systems is necessary for healthy sexual function in men. The first essential event for male sexual activity is the occurrence and continuity of penile erection.[1] Erectile dysfunction (ED) is defined as the inability to obtain and maintain a sufficient erection for satisfactory sexual performance.[2] The etiology of ED has been mainly classified as organic, psychogenic, and mixed.[3] Organic-origin ED is divided into six subgroups: neurogenic, hormonal, vascular, anatomic, trauma-related, and drug-related and accounts for 80% of all causes of ED.[4-7] Vascular-origin ED is the major cause of organic-origin EDs and endothelial dysfunction is the most important physiopathology. Vascular-origin EDs are evaluated as arterial insufficiency and veno‑occlusive dysfunction (VOD). The veno-occlusive mechanism, which is one of the most important stages of penile tumescence, depends on the balance between the smooth muscle and connective tissue in the corpus cavernosum.[8] Penile color doppler ultrasonography (PCDU) provides insight into the arterial and venous hemodynamic condition of the penis,[9] and this is the first step of the evaluation of vascular pathologies in patients with ED. In patients suspected to have VOD with PCDU, dynamic infusion cavernosometry and cavernosography performed following intracavernosal pharmaco-stimulation are accepted as effective methods in showing venous leakage precisely.[10] Although combined use of these two methods raises the probability of diagnosis, both methods can also be used alone. The objective of this study was to investigate the sufficiency of PCDU and the additional contribution of cavernosography to the diagnosis of ED due to VOD.
Conclusion
In our study, according to the results obtained from cavernosography, the diagnosis was correctly established in more than 95% of the patients who were found to have VOD with PCDU. This result indicates that PCDU is highly sufficient in the diagnosis of veno‑occlusive ED. Cavernosography is a more invasive diagnostic method than PCDU. PCDU is recommended in cases where venous surgery or embolization is not considered, whereas cavernosography is not recommended for these patients.
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