Is Penile Doppler Ultrasonography Overdiagnosed?

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2023 Apr 24

PMID 37090351

Authors

Mehmet Y Salman

Serkan Dogan

Kenan Y Yildiz

Affiliations

Soon will be listed here.

Abstract

Aim: The objective of this study was to determine whether penile Doppler ultrasonography (USG) examinations, combined with the administration of intracavernosal vasoactive agents, were correctly performed as a second-line diagnostic method with the proper indications in a select patient group.

Methods: A total of 200 patients who underwent penile Doppler ultrasounds in our clinic were included in the study. Patients' demographic data were collected, information about their medical-sexual history was taken, physical examinations were performed, and laboratory analyses were conducted. Patients were informed in detail about the process, and their consent was given prior to the study. Procedure outcomes and complications were also recorded. The relationship of vasculogenic pathologies was analysed, and the rate of abnormal results and complications was compared with the existing literature.

Results: Following the investigations, abnormal results were found in 24.5% of patients, while this rate was 6.8% in patients under the age of 40. Arterial insufficiency was found in 31 patients and venous insufficiency in 18 patients. Five patients had both pathologic conditions. No statistically significant correlation was found between arterial insufficiency and age, while venous insufficiency was significantly correlated with age (p=0.006).

Conclusion: Penile Doppler ultrasounds should only be ordered for a carefully selected patient group. Ordering ultrasounds without a proper indication can result in unnecessary labour and financial loss, as well as an increase in invasive procedures.

References

Lue T, Hricak H, Marich K, Tanagho E . Vasculogenic impotence evaluated by high-resolution ultrasonography and pulsed Doppler spectrum analysis. Radiology. 1985; 155(3):777-81. DOI: 10.1148/radiology.155.3.3890009. View

Sikka S, Hellstrom W, Brock G, Martin Morales A . Standardization of vascular assessment of erectile dysfunction: standard operating procedures for duplex ultrasound. J Sex Med. 2012; 10(1):120-9. DOI: 10.1111/j.1743-6109.2012.02825.x. View

Salonia A, Bettocchi C, Boeri L, Capogrosso P, Carvalho J, Cilesiz N . European Association of Urology Guidelines on Sexual and Reproductive Health-2021 Update: Male Sexual Dysfunction. Eur Urol. 2021; 80(3):333-357. DOI: 10.1016/j.eururo.2021.06.007. View

Shiri R, Koskimaki J, Hakama M, Hakkinen J, Tammela T, Huhtala H . Effect of chronic diseases on incidence of erectile dysfunction. Urology. 2003; 62(6):1097-102. DOI: 10.1016/j.urology.2003.07.001. View

Hatzichristou D, Kirana P, Banner L, Althof S, Lonnee-Hoffmann R, Dennerstein L . Diagnosing Sexual Dysfunction in Men and Women: Sexual History Taking and the Role of Symptom Scales and Questionnaires. J Sex Med. 2016; 13(8):1166-82. DOI: 10.1016/j.jsxm.2016.05.017. View

Gratzke C, Angulo J, Chitaley K, Dai Y, Kim N, Paick J . Anatomy, physiology, and pathophysiology of erectile dysfunction. J Sex Med. 2010; 7(1 Pt 2):445-75. DOI: 10.1111/j.1743-6109.2009.01624.x. View

Khanzada U, Khan S, Hussain M, Adel H, Masood K, Adil S . Evaluation of the Causes of Erectile Dysfunction in Patients Undergoing Penile Doppler Ultrasonography in Pakistan. World J Mens Health. 2017; 35(1):22-27. PMC: 5419116. DOI: 10.5534/wjmh.2017.35.1.22. View

Johannes C, Araujo A, Feldman H, Derby C, Kleinman K, McKinlay J . Incidence of erectile dysfunction in men 40 to 69 years old: longitudinal results from the Massachusetts male aging study. J Urol. 2000; 163(2):460-3. View

Lewis R, Fugl-Meyer K, Corona G, Hayes R, Laumann E, Moreira Jr E . Definitions/epidemiology/risk factors for sexual dysfunction. J Sex Med. 2010; 7(4 Pt 2):1598-607. DOI: 10.1111/j.1743-6109.2010.01778.x. View

10.

Azab S, Salem A, Nabil Ismail N, El Khiat Y, El Gebally M . Penile hemodynamics study in erectile dysfunction men: the influence of smoking obesity on the parameters of penile duplex. Int Urol Nephrol. 2020; 52(6):1015-1025. DOI: 10.1007/s11255-020-02405-1. View

11.

Bari V, Ahmed M, Rafique M, Ashraf K, Memon W, Usman M . Evaluation of erectile dysfunction with color Doppler sonography. J Pak Med Assoc. 2006; 56(6):258-61. View

12.

Aversa A, Bruzziches R, Spera G . Diagnosing erectile dysfunction: the penile dynamic colour duplex ultrasound revisited. Int J Androl. 2005; 28 Suppl 2:61-3. DOI: 10.1111/j.1365-2605.2005.00587.x. View

13.

Ardicoglu A, Kocakoc E, Tuygun U, Bozgeyik Z, Orhan I . Effectiveness of vardenafil versus papaverine in penile Doppler ultrasonography. Urol Int. 2005; 75(1):75-9. DOI: 10.1159/000086212. View

14.

Capogrosso P, Colicchia M, Ventimiglia E, Castagna G, Clementi M, Suardi N . One patient out of four with newly diagnosed erectile dysfunction is a young man--worrisome picture from the everyday clinical practice. J Sex Med. 2013; 10(7):1833-41. DOI: 10.1111/jsm.12179. View

15.

Yildirim D, Bozkurt I, Gurses B, Cirakoglu A . A new parameter in the diagnosis of vascular erectile dysfunction with penile Doppler ultrasound: cavernous artery ondulation index. Eur Rev Med Pharmacol Sci. 2013; 17(10):1382-8. View

16.

Prezioso D, Iacono F, Russo U, Romeo G, Ruffo A, Russo N . Evaluation of penile cavernosal artery intima-media thickness in patients with erectile dysfunction. A new parameter in the diagnosis of vascular erectile dysfunction. Our experience on 59 cases. Arch Ital Urol Androl. 2014; 86(1):9-14. DOI: 10.4081/aiua.2014.1.9. View

17.

Shigehara K, Namiki M . Clinical Management of Priapism: A Review. World J Mens Health. 2016; 34(1):1-8. PMC: 4853765. DOI: 10.5534/wjmh.2016.34.1.1. View

18.

Ghanem H, Salonia A, Martin-Morales A . SOP: physical examination and laboratory testing for men with erectile dysfunction. J Sex Med. 2012; 10(1):108-10. DOI: 10.1111/j.1743-6109.2012.02734.x. View

19.

Kubin M, Wagner G, Fugl-Meyer A . Epidemiology of erectile dysfunction. Int J Impot Res. 2003; 15(1):63-71. DOI: 10.1038/sj.ijir.3900949. View

20.

Lee W, Kim Y, Choi H . Psychogenic versus primary organic impotence. Int J Impot Res. 1994; 6(2):93-7. View