Assessment of predictors of abnormal peak systolic velocity and end diastolic velocity in penile doppler ultrasound
Habous, M1; Giona, S2; Williamson, B3; Mekawi, Z1; Abdelrahman, Z1; Nassar, M1; Binsaleh, S4; Muir, G2
1: Elaj Medical Centers, Saudi Arabia; 2: King’s College Hospital,London,UK; 3: University Hospitals Birmingham, Birmingham, UK; 4: King Said university,Riyadh,Saudi Arabia
Introduction: Penile duplex Doppler ultrasound (PDDU) is used to assess the etiology of erectile dysfunction(ED). Peak systolic velocity (PSV), and end-diastolic velocity (EDV), are the main PDDU parameters.
Objectives: to evaluate the impact of different cardiovascular risk factors, Peyroni disease(PD), and penile size on PSV and EDV.
Materials and Methods: A retrospective review of all men presenting with erectile dysfunction (ED) who did PDDU between January 2011 and January 2012 has been carried out, including patients diagnosed as psychogenic ED. A total of 362 patients with complete data were included in this analysis. Collected data included patient demographics, vascular, and anatomic parameters. The patients’ data included known cardiovascular risk factors (age, tobacco consumption, body mass index (BMI), testosterone levels(T), diabetes mellitus(DM), hypertension(HTN), dyslipidemia and PD. Penile size was measured at the time of full erection on the dorsal aspect of the penis, from the pubic bone to tip of the glans(BTT),from skin to tip(STT) and circumference of base of penis. PDDU was done for all patients after intracavernosal injection(ICI) with Trimix. PSV and EDV were measured after 15 minutes.
Results: The mean age was 48(23-81),and the mean BMI was 30(18-51). Using SPSS the following associations are apparent: Older patients have lower PSV (r=-0.361, P=0.000) which is highly statistically significant. Diabetics have lower PSV (r=-0.318, P=0.000) which is highly statistically significant. Hypertensive patients have lower PSV(r=-0.296, P=0.000) which is highly statistically significant. Smokers have lower PSV (r=-0.140, P=0.008) which is highly statistically significant. Interestingly there was neither significant correlation between BMI and PSV (0.16, p=0.745) nor significant correlation between testosterone and PSV (0.029, p=0.552). Also, there was no correlation between PSV and both dyslipidaemia and penile size.
Conclusion: Older age, tobacco consumption, DM and hypertension have a negative impact on penile hemodynamics, which was statistically significant. There was no statistically significant effect on penile hemodynamics in patients with increased BMI, low testosterone, PD or according to the size of the penis.
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