The Role of Shear Wave Elastography on Evaluation of the Rigidity Changes of Corpus Cavernosum Penis in Venogenic Erectile Dysfunction

Objective: The goal of this study was to evaluate the effect of shear wave elastography (SWE) on the measurement of rigidity changes of penile erection in venogenic erectile dysfunction (ED) and in rigidity alterations of corpus cavernosum penis with age in normal population.

Methods: The study was a prospective analysis of 81 patients referred to the department of urology with complaints of ED as well as 35 healthy volunteers. SWE was performed on the corpus cavernosum penis (CCP) in the flaccid state of healthy group. The patients were divided into venogenic ED (31 patients) and non-vascular ED (neither arterial insufficiency nor venogenic dysfunction) (36 patients) by performing color doppler ultrasonography in association with intracavernous injection (ICI). SWE measurements were performed in CCP in the flaccid state, after 15-20 min and 25-30 min of ICI in both patients groups. Differences between groups were compared.

Results: Age was significantly negatively associated with SWE values of CCP among three groups (healthy group: r = -0.584, p < 0.05; venogenic ED group: r = -0.468, p < 0.05; non-vascular ED group: r = -0.539, p < 0.05). There was no significant difference between the SWE values of three groups in the flaccid state (p > 0.05). The mean SWE values of CCP were significantly lower in the erectile state (15-20 min after ICI) compared with the flaccid state in two patients groups (p < 0.05). The mean SWE values of CCP after ICI increased with time (from 15-20 min to 25-30 min) in patients with venogenic ED (p < 0.05), while the SWE values of CCP after ICI did not statistically significantly differ with time in patients with non-vascular ED (p > 0.05).

Conclusion: SWE is expected to be a promising approach in terms of the etiological diagnosis of ED and the quantitative evaluation of alternations of penile structures with age.