Skip to main content
SpringerLink
Log in
Book cover

Male Infertility and Sexual Dysfunction pp 367–395Cite as

Color Duplex Doppler Ultrasound: Penile Blood Flow Study

  • Chapter

  • 399 Accesses

Abstract

A recent estimate of the number of men in the United States suffering with complete erectile dysfunction is 10 to 20 million. When partial erectile dysfunction is included, the estimate jumps to 30 million.1 Age-specific prevalence is estimated to be 5% at age 40, increasing to 15% to 25% by age 65. In clinical series, the ratio of organic to psychologic male sexual dysfunction also varies with age: 70% of patients under 35 years of age have a psychogenic cause, and 85% of patients over 50 years of age have organic impotence.2 Patient accounts of coital frequency similarly vary with age: 75% of men in their seventh decade report having coitus once monthly, and 37% of patients 60 to 69 years old describe having weekly coitus.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Consensus development conference statement: impotence. National Institutes of Health. JAMA 1993; 270:83–90.

    Article  Google Scholar 

  2. Meilinger B, Weiss J. Sexual dysfunction in the elderly male. Am Urol Assoc Update Series 1992; 11: 146–152.

    Google Scholar 

  3. Feldman HA, Goldstein I, Hatzichristou DG, et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. Int J Impotence Res 1992; 4(suppl 2):AI7.

    Google Scholar 

  4. Broderick GA, Arger PA. Duplex doppler ultrasonography: noninvasive assessment of penile anatomy and function. Semin Roentgenol 1993; 28: 43–56.

    Article  PubMed  CAS  Google Scholar 

  5. Landwehr P. Penile vessels: erectile dysfunction. In: Wolf K-J, Fobbe F, eds. Color Duplex Sonography: Principles and Clinical Application. Stuttgart: Thieme; 1995: 204–215.

    Google Scholar 

  6. Herbener TE, Seftel AD, Nehra A, et al. Penile ultrasound. Semin Urol 1994; 12: 320–332.

    PubMed  CAS  Google Scholar 

  7. King BF, Lewis RW, Mckusick MA. Radiologic evaluation of impotence. In: Bennett AH, ed. Impotence. Philadelphia: W.B. Saunders; 1994: 52–91.

    Google Scholar 

  8. Gaskell P. The importance of penile blood pressure in cases of impotence. Can Med Assoc J 1971; 105: 104.

    Google Scholar 

  9. Abelson D. Diagnostic value of the penile pulse and blood pressure: a Doppler study of impotence in diabetics. J Urol 1975; 113: 636.

    PubMed  CAS  Google Scholar 

  10. Michal V, Kramer R, Pospichal J. External iliac “steal syndrome.” J Cardiovasc Surg 1978; 19: 355.

    CAS  Google Scholar 

  11. Goldstein I, Siroky MB, North RI, et al. Vasculogenic impotence: role of the pelvic steal test. J Urol 1982; 128: 300.

    PubMed  CAS  Google Scholar 

  12. Schwartz AN, Lowe MA, Ireton R, et al. A comparison of penile brachial index and angiography: evaluation of corpora cavernosa arterial inflow. J Urol 1990; 143: 510.

    PubMed  CAS  Google Scholar 

  13. Rajfer J, Canan V, Dorey FJ, et al. Correlation between penile angiography and duplex scanning of cavernous arteries in impotent men. J Urol 1990; 143: 1128–1130.

    PubMed  CAS  Google Scholar 

  14. Bahren W, Gall H, Scherb W, et al. Arterial anatomy and arteriographic diagnosis of arterio-genic impotence. Cardiovasc Intervent Radiol 1988; 11: 195–210.

    Article  PubMed  CAS  Google Scholar 

  15. Bookstein JJ, Lange EV. Penile magnification pharmacoarteriography: details of intrapenile arterial anatomy. AJR 1987; 148: 883.

    PubMed  CAS  Google Scholar 

  16. Breza J, Aboseif SR, Orivs BR, et al. Detailed anatomy of penile neurovascular structures: surgical significance. J Urol 1989; 141: 437–443.

    PubMed  CAS  Google Scholar 

  17. Polascik TJ, Walsh PC. Radical retropubic prostatectomy: the influence of accessory pudendal arteries on the recovery of sexual function. J Urol 1995; 153: 150–152.

    Google Scholar 

  18. Curet P, Grellet J, Perrin D, et al. Technical and anatomic factors in filling of distal portion of internal pudendal artery during arteriography. Urology 1987; 29: 333.

    Article  PubMed  CAS  Google Scholar 

  19. Rosen MP, Greenfield AJ, Walker TG, et al. Arteriogenic impotence: findings in 195 impotent men examined with selective internal pudendal angiography. Radiology 1990; 174: 1043.

    PubMed  CAS  Google Scholar 

  20. Garibyan H, Lue TF. Anastomotic network between the dorsal and cavernous arteries in the penis. J Urol 1990; 143: 221A.

    Google Scholar 

  21. Gall H, Bahren W, Scherb W, et al. Diagnostic accuracy of Doppler ultrasound technique of the penile arteries in correlation to selective arteriography. Cardiovasc Intervent Radiol 1988; 11: 225.

    Article  PubMed  CAS  Google Scholar 

  22. Virag R, Frydman D, Legman M, et al. Intracavernous injection of papaverine as a diagnostic and therapeutic method in erectile failure. Angiology 1984; 35: 79.

    Article  PubMed  CAS  Google Scholar 

  23. Lue TF. Impotence: a patient’s goal directed approach to treatment. World J Urol 1990; 8: 67.

    Article  Google Scholar 

  24. Pescatori ES, Hatzichristou DG, Namburi S, et al. A positive intracavernous injection test implies normal veno-occlusive but not necessarily normal arterial function: a hemodynamic study. J Urol 1994; 151: 1209–1216.

    PubMed  CAS  Google Scholar 

  25. Lue TF, Hricak H, Marich KW, et al. Vasculogenic impotence evaluated by high resolution ultrasonography and pulsed Doppler spectrum analysis. Radiology 1985; 155: 777.

    PubMed  CAS  Google Scholar 

  26. McAninch JW, Laing FC, Jeffrey RB. Sonoure-thrography in the evaluation of urethral strictures. J Urol 1988; 139: 294–297.

    PubMed  CAS  Google Scholar 

  27. Benson CB, Doubilet PM, Richie JP. Sonography of the male genital tract. AJR 1989; 153: 705–713.

    PubMed  CAS  Google Scholar 

  28. Oates CP, Pickard PH, Powell PH, et al. The use of duplex ultrasound in the assessment of arterial supply to the penis in vasculogenic impotence. J Urol 1995; 153: 354–357.

    Article  PubMed  CAS  Google Scholar 

  29. Banya Y, Ushiki, Takagane H, et al. Two circulatory routes within the human corpus cavernosum penis: a scanning electron microscopic study of corrosion casts. J Urol 1989; 979: 883.

    Google Scholar 

  30. Bookstein JJ. Cavernosal venooclusive insufficiency in male impotence: evaluation of degree and location. Radiology 1987; 164: 175.

    PubMed  CAS  Google Scholar 

  31. Aboseif SR, Lue TF. Hemodynamics of penile erection. Urol Clin North Am 1988; 15: 1–7.

    PubMed  CAS  Google Scholar 

  32. Andersson K-E, Wagner G. Physiology of penile erection. Physiol Rev 1995; 75: 191–223.

    PubMed  CAS  Google Scholar 

  33. Linet Ol, Ogrinc FG. Efficacy and safety of intracavernosal alprostadil in men with erectile dysfunction. N Engl J Med 1996; 334: 873–877.

    Article  PubMed  CAS  Google Scholar 

  34. Schwartz AN, Wang KY, Mack LA, et al. Evaluation of normal erectile function with color flow Doppler sonography. AJR 1989; 153: 1155–1160.

    PubMed  CAS  Google Scholar 

  35. Quam JP, King BF, James EM, et al. Duplex and color Doppler monographic evaluation of vasculogenic impotence. AJR 1989; 153: 1141–1147.

    PubMed  CAS  Google Scholar 

  36. Paushter DM. Role of duplex sonography in the evaluation of sexual impotence. AJR 1989; 153: 116.

    Google Scholar 

  37. Collins JP, Lewandowski BJ. Experience with intracorporeal injection of papaverine and duplex ultrasound scanning for the assessment of arteriogenic impotence. Br J Urol 1987; 59: 84.

    Article  PubMed  CAS  Google Scholar 

  38. Herbner TE, Seftel AD, Nehra A et al. Penile ultrasound. Semin Urol 1994; 12: 320–332.

    Google Scholar 

  39. Burns PN. Hemodynamics and interpretation of Doppler signals. In: Taylor KJW, Burns PN, Wells PNT, eds. Clinical Applications of Doppler Ultrasound. New York: Raven Press; 1987.

    Google Scholar 

  40. Burns PN. Physical principles of Doppler ultrasound and spectral analysis. J Clin Ultrasound 1987; 15: 567–590.

    Article  PubMed  CAS  Google Scholar 

  41. Foley WD, Erickson SJ. Color Doppler flow imaging. AJR 1991; 156: 3–13.

    PubMed  CAS  Google Scholar 

  42. Merritt CR. Doppler color flow imaging. J Clin Ultrasound 1987; 15: 591–597.

    Article  PubMed  CAS  Google Scholar 

  43. Broderick GA, Lue TF. The penile blood flow study: evaluation of vasculogenic impotence. In: Jonas U, Thon WF, Stief CG, eds. Erectile Dysfunction. Berlin, Heidelberg, New York: Springer-Verlag; 1991.

    Google Scholar 

  44. Wegner HEH, Andersen R, Knispel HH, et al. Evaluation of penile arteries with color coded duplex sonography: prevalence and possible therapeutic implications of connections between dorsal and cavernous arteries in impotent men./Urol 1995; 153: 1469–1471.

    Article  CAS  Google Scholar 

  45. Paick JS, Won Lee S, Hyup Kim S. Doppler sonography of deep cavernosal artery of the penis: variation of peak systolic velocity according to sampling location. Int J Impotence Res 1994; 6: A34.

    Google Scholar 

  46. Chung WS, Park YY, Back SY. The effect of measurement location of the blood flow parameters on their values during Duplex sonography. Int J Impotence Res 1994; 6: A29.

    Google Scholar 

  47. Govier FE, Asase D, Hefty TR, et al. Timing of penile color flow duplex ultrasonography using a triple drug mixture. J Urol 1995; 153: 1472–1475.

    Article  PubMed  CAS  Google Scholar 

  48. Meuleman EJH, Bemelmans BLH, Doesburg WH, et al. Penile pharmacological duplex ultrasonography: a dose effect study comparing papaverine, papaverine/phentolamine and PGEt. J Urol 1992; 148: 63.

    PubMed  CAS  Google Scholar 

  49. Fitzgerald SW, Erickson SJ, Foley WD, et al. Color Doppler sonography in the evaluation of erectile dysfunction: patterns of temporal response to papaverine. AJR 1991; 157: 331–336.

    PubMed  CAS  Google Scholar 

  50. Lue TF, Donatucci CF. The combined intra-cavernous injection and stimulation test: diagnostic accuracy. J Urol 1992; 148: 61–62.

    PubMed  Google Scholar 

  51. Nehra A, Hakim LS, Abokar RA, et al. A new method of performing duplex Doppler ultrasonography: effect of re-dosing of vasoactive agents on hemodynamic parameters. J Urol 1995; 153: 415A.

    Google Scholar 

  52. Montorsi F, Guazzoni G, Barbieri L, et al. The effect of intracorporeal injection plus genital and audiovisual sexual stimulation vs second injection on penile color Doppler sonography parameters. J Urol 1996; 155: 536–540.

    Article  PubMed  CAS  Google Scholar 

  53. Lue TF, Hricak H, Marich KW, et al. Evaluation of arteriogenic impotence with intracorporeal injection of papaverine and the duplex ultrasound scanner. Semin Urol 1987; 3: 43–48.

    Google Scholar 

  54. Fitzgerald SW, Krysiewicz S, Mellinger C. The role of imaging in the evaluation of impotence. AJR 1989; 53: 1133–1139.

    Google Scholar 

  55. Ishii N, Watanabe H, Irisawa C, et al. Intracavernous injection of prostaglandin Ej for the treatment of erectile impotence. J Urol 1989; 141: 323–325.

    PubMed  CAS  Google Scholar 

  56. Golub M, Zia P, Matsuno N, et al. Metabolism of prostaglandins, A-I and E-l in men. J Clin Invest 1979; 59: 1404.

    Google Scholar 

  57. Hamberg M. Biosynthesis of prostaglandin Ex by human seminal vesicles. Lipids 1976; 11: 249.

    Article  PubMed  CAS  Google Scholar 

  58. Hedquist P. PGEj and prostaglandin synthesis inhibitors of norepinephrine release from vascular tissue. In: Robinson HJ, Vane ER, eds. Prostaglandin Synthetase Inhibitors. New York: Raven Press; 1973: 303.

    Google Scholar 

  59. Meuleman EFJ, Bemelmans BLR, et al. Assessment of penile blood flow by duplex ultrasonography in 44 men with normal erectile potency in different phases of erection. J Urol 1992; 147: 51–56.

    PubMed  CAS  Google Scholar 

  60. Mellinger BC, Fried JJ, Vaughan ED. Papaverine induced penile blood flow acceleration in impotent men measured by duplex scanning. J Urol 1990; 144: 897.

    PubMed  CAS  Google Scholar 

  61. Lue TF, Tanagho EA. Physiology of erection and pharmacological management of impotence. J Urol 1987; 137: 829.

    PubMed  CAS  Google Scholar 

  62. Benson CB, Vickers MA. Sexual impotence caused by vascular disease: diagnosis with duplex sonography. AJR 1989; 153: 1149.

    PubMed  CAS  Google Scholar 

  63. Shabsigh R, Fishman IF, Quesada ET, et al. Evaluation of vasculogenic erectile impotence using penile duplex ultrasonography. J Urol 1989; 142: 1469.

    PubMed  CAS  Google Scholar 

  64. Benson CB, Aruny JE, Vickers MA. Correlation of duplex sonography with arteriography in patients with erectile dysfunction. AJR 1993; 160: 71–73.

    PubMed  CAS  Google Scholar 

  65. Shabsigh R, Fishman IJ, Shottland Y, et al. Comparison of penile duplex utrasonography with nocturnal penile tumescence monitoring for the evaluation of erectile impotence. J Urol 1990; 143: 924.

    PubMed  CAS  Google Scholar 

  66. Lewis RW, King BF. Dynamic color Doppler sonography in the evaluation of penile erectile disorders. Int J Impotence Res 1994; 6: A30.

    Google Scholar 

  67. Rhee E, Osborn A,Witt M. The correlation of cavernous systolic occlusion pressure with peak velocity flow using color duplex Doppler ultrasound. J Urol 1995; 153: 358–360.

    Article  PubMed  CAS  Google Scholar 

  68. Schwartz AN, Lowe MA, Berger RE, et al. Assessment of normal and abnormal erectile function; color Doppler flow sonography vs. conventional techniques. Radiol Sei North Am 1991; 180: 105–109.

    CAS  Google Scholar 

  69. Planiol T, Pourcelot L. Doppler effect study of the carotid circulation. In: de Vlieger M, White DN, McCready VR, eds. Ultrasonics in Medicine. Amsterdam: Excerpta Medica; 1974; 104–111.

    Google Scholar 

  70. Kaplan HS. The concept of presbyrectia. Int J Impotence Res 1989; 1: 59.

    Google Scholar 

  71. Wespes E, deGoes PM, Schulman C. Vascular impotence: focal or diffuse penile disease. J Urol 1992; 148: 1435–1436.

    PubMed  CAS  Google Scholar 

  72. Kim N, Vardi Y, Padma-Nathan H, et al. Oxygen tension regulates the nitric oxide pathway. Physiological role in penile erection. J Clin Invest 1993; 91: 3006–3012.

    Article  Google Scholar 

  73. Saenz de Tejada I, Mooreland RB. Physiology of erection, pathophysiology of impotence, and implications of GE1 in the control of collagen synthesis in the corpus cavernosum. Proceedings of a Symposium, Kalamazoo, August 3–4, 1993. Excerpta Medica, pp. 3–16.

    Google Scholar 

  74. Levin RM, Hypolite JA, Broderick GA. Dissociation of basal and stimulated tonic contraction of the corpus cavernosum with intracellular calcium during hypoxia. J Urol 1995; 153: A405.

    Article  Google Scholar 

  75. Broderick GA, Arger PA. Penile blood flow study: age specific references ranges. J Urol 1994; 151: A371.

    Google Scholar 

  76. Hinman F Jr. Priapism, reasons for failure of therapy. J Urol 1960; 83: 420.

    PubMed  Google Scholar 

  77. Broderick GA, Lue TF. Priapism and physiology of erection. AUA Update Series 1988; 7: 225–232.

    Google Scholar 

  78. Broderick GA, Harkaway R. Pharmacologic erection: time-dependent changes in the corporal environment. Int J Impotence Res 1994; 6: 9–16.

    CAS  Google Scholar 

  79. Witt MA, Goldstein I, Saenz de Tejada I, et al. Traumatic laceration of intracavernosal arteries: the pathophysiology of nonischemic, high flow arterial priapism. J Urol 1990; 143: 129–132.

    PubMed  CAS  Google Scholar 

  80. Walker TG, Gran PW, Goldstein I, et al. High-flow priapism: treatment with superselective transcatheter embolization. Radiology 1990; 174: 1053–1054.

    PubMed  CAS  Google Scholar 

  81. Hakim LS, Kulaksizoglu H, Mulligan R, et al. Evolving concepts in the diagnosis and treatment of arterial high flow priapism. J Urol 1996; 155: 541–548.

    Article  PubMed  CAS  Google Scholar 

  82. Gasior BL, Levine FJ, Sowannesian A, et al. Plaque associated corporal veno-occlusive dysfunction in idiopathic Peyronie’s disease: a pharmacocavernosometric and pharmacocaver-nosographic study. World J Urol 1990; 8: 90.

    Article  Google Scholar 

Download references

Authors
  1. Gregory A. Broderick
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Section of Andrology and Male Infertility Department of Urology, Tulane University School of Medicine, 1430 Tulane Avenue SL 42, 70112-2699, New Orleans, LA, USA

    Wayne J. G. Hellstrom (Associate Professor Urology, Chief) (Associate Professor Urology, Chief)

Rights and permissions

Reprints and permissions

Copyright information

© 1997 Springer Science+Business Media New York

About this chapter

Cite this chapter

Broderick, G.A. (1997). Color Duplex Doppler Ultrasound: Penile Blood Flow Study. In: Hellstrom, W.J.G. (eds) Male Infertility and Sexual Dysfunction. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-1848-7_27

Download citation

  • DOI: https://doi.org/10.1007/978-1-4612-1848-7_27

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-7310-3

  • Online ISBN: 978-1-4612-1848-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation