Evaluation of the Causes of Erectile Dysfunction in Patients Undergoing Invasive Penile Doppler Sonography: A Study of Adult Pakistani Population

Background: In patients with erectile dysfunction it is important to differentiate psychogenic from organic causes. Color Doppler sonography of penis is a relatively inexpensive and partially invasive tool for this purpose. This study was conducted to evaluate the causes of erectile dysfuction in the adult population of Pakistan, who underwent penile doppler sonography. Methods: This retrospective cross sectional study was conducted at the Dow Institute of Radiology, Dow University of Health Sciences, Karachi, Pakistan. All consecutive patients presenting with the complaints of erectile dysfunction and undergoing penile doppler sonography from July, 2014 till June, 2016 were included in this study (n = 97). The examination was performed by a radiologist with more than five years experience in small parts ultrasonography. All examinations were performed on GE Voluson S6 and GE Logiq P5 with a high frequency probe. Following baseline scans, intracavernosal injection of 20 μg of prostaglandin E1 was given close to the base of penis. Peak systolic velocity and end diastolic velocity were measured in each cavernosal artery at the interval of 5 minutes. Patients with a peak systolic velocity of less than 25 cm/sec were considered to have arterial insufficiency. A greater than 5 cm/sec end diastolic velocity was used to describe venous incompetence. Erection grading of penis at the interval of ten minutes was done by erection hardness grading score. Results: Out of 97 patients (mean age 37.09 ± 11.59 years; range 19-69); 50 (51.5%) patients had normal penile Doppler sonographic findings, 24 (24.7%) had arterial insufficiency, 15 (15.5%) had venous leak, while 8 (8.2%) patients had arterial insufficiency with venous leak. Conclusions: Penile doppler sonography is a useful tool for evaluation of causes of erectile dysfunction. The majority of studied Pakistani individuals demonstrated no organic cause, thus conforming to the high prevalence of psychogenic etiology.

Publication History

Article published online:
26 April 2021