Clinical Study Of Color Doppler Ultrasonography In The Diagnostic Evaluation Of Erectile Dysfunction

Objective:To assess the role of Color-Doppler ultrasonography in the evaluation of patients with erectile dysfunction (ED).Data and Methods:Totally88ED patients with an age range of18-54(median age29) were included in our study。The patients who was considered as vasculogenic erectile dysfunction was selected by history、Physical examination、laboratory examination and NPT examination。After papaverine (15mg)/phentolamine (lmg) was injected into cavernous body of penis, hemodynamic parameters of cavernous artery including the peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistance index (RI) were measured by Color-Doppler ultrasonography, at the same time, the penile rigidity was detected. The degree of penile rigidity was classified into4grades (Ⅳ°、Ⅲ°、Ⅱ°、Ⅰ°).The correlation between the penile rigidity state and its hemodynamic parameters was analyzed.Results:In88ED patients,14patients in Ⅳ°group,26patients in Ⅲ°group,32patients in Ⅱ°group,16patients in Ⅰ°group。Averages of PSV in four groups are52.07cm/s、47.88cm/s,33.99cm/s、25.48cm/s, there was significant difference of PSV in four groups except Ⅲ°/Ⅳ°; Average of EDV in four groups are1.94cm/s、3.59cm/s、4.43cm/s、5.29cm/s,there was significant difference of PSV in four groups except Ⅰ°/Ⅱ°、Ⅱ°/Ⅲ°. Average of RI in four groups are0.96、0.92、0.86、0.79,there was significant difference of RI in four groups. According to whether the penis can insert into the vagina,88ED patients, were divided into2groups.-positive erection group (including Ⅳ°、Ⅲ°), negtive erection group (including Ⅱ°、Ⅰ°).The area of PSV、EDV、RI below the receiver-operating-characteristic curve (ROC curve) were0.91、0.92、0.78.RI has the largest, so, it is more helpful than other parameters in the diagnosis of vasculogenic ED patients.The cut values of the hemodynamic parameters are follows:PSV=45cm/s,EDV=4.5cm/s,RI=0.9。Comparison of the percentage of the positive erection:RI>0.9(79.2%) VS RI>0.9and EDV<4.5cm/s (82.6%) VS RI>0.9and PSV>45cm/s (87.5%) VS RI>0.9and PSV>45cm/s and EDV<4.5cm/s (100%); Comparison of the percentage of the negative erection:RI<0.9(90%) VS RI<0.9and EDV>4.5cm/s(91.7%) VS RI<0.9and PSV<45cm/s(100%) VS RI<0.9and PSV<45cm/s and EDV>4.5cm/s(100%).Conclusion:Color-Doppler ultrasonography is an examination that is with no wound. It effectively helps the diagnosis of vasculogenic ED. But the hemodynamic parameters near to the cut off values can not give clear diagnosis results.Combine the hemodynamic parameters with each other can improve the accuracy of the diagnosis.