The effect of real-time erectile rigidity tested by Rigiscan on diagnosis of erectile dysfunction
Peng, J1; Fang, D1; Zhang, ZC1
1: Peking University First Hospital, China
Objectives: Penile color duplex ultrasonography (CDU) is believed as an effective measure for penile artery and venous function and a common objective test for etiological diagnosis of erectile dysfunction(ED). But it is an invasive test and some patients are unwilling to undergo this test. This study aimed to investigate if real-time rigidity test by Rigiscan could predict the CDU results.
Materials and methods: 306 patients suspected ED were included in this study from 2014 to 2016. All patients were performed real-time rigidity test by Rigiscan after taking sildenafil 100mg one hour and receiving audiovisual sexual stimulation (AVS). All patients were performed CUD in another day after intracavernous injection of Alprostadil 10mg 15 minutes.
Results: The median age was 29 years old. The median course of ED was 1.5 (range from 0.5 to 4) years. The mean IIEF-5 score was 6.25. The median maximal rigidity tested by AVS-Rigiscan was 30% (0-40%) at the tip and 35% (0-50%) at the base. The median duration was 6 (1-18) minutes. The vascular function tested by CDU was normal in 137 patients and abnormal in 169 patients. There was no statistical correlation between CDU results and age (p=0.869), duration of disease (p=0.596) and IIEF-5 score (p=0.450). As for the relationship with AVS results, although not related to erectile duration (p=0.180), significant higher maximal rigidity was noted both at tip (p=0.035) and at base (p=0.019) in patients with normal CDU results. The ROC curves indicating the relationship between CDU results and the maximal rigidity were made with an AUC of 0.575 for tip and 0.571 for base. A maximal Youden’s index was found when maximal rigidity was over 37.5% at tip and 30.5% at base. A combined ROC curved was generated and the highest Youden’s index was achieved when a cut-off was set at rigidity over 37.5% at tip and 30.5% at base, with satisfied sensitivity and negative predictive value.
Conclusions: Penile erectile rigidity tested by AVS-Rigiscan could help predict the results of duplex ultrasound in the diagnosis of ED. A rigidity of 37.5% at tip and 30.5% at base could indicate a possibly normal result in duplex ultrasound and patients might be spared from invasive examinations.
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