Tehran University Medical Journal

Background: Arterial insufficiency is a well-recognized etiology of erectile dysfunction. Moreover, nowadays it is appreciated that it can herald silent coronary artery disease in involved patients. However color Doppler study of penis with intracavernosal injection (ICI) of Papaverin, as a helpful diagnostic study, is somehow time consuming and technically demanding, as a result, radiologists are reluctant to accomplish. Hence, in a search for more plausible parameters, we were determined to validate PSV in flaccid state for predicting possible arterial insufficiency in patients.

Methods: In a cross sectional study to evaluate diagnostic tests, accomplished in Hasheminejad Urology center in Tehran throughout 2011, we studied 59 patients with the complaint of erectile dysfunction. They were referred to our ultrasound clinics by urologists in order to undergo color Doppler study of penis by ICI of Papaverin. They were studied comprehensively before and after injection. Primary and secondary diagnostic criteria of arterial disease in color Doppler and consequently the physiologic event of full erection were designated as gold standard diagnostic considerations. The resulted data were matched and analyzed with SPSS software.

Results: Fifty nine patients underwent the study, with the mean age of 45.6 ± 13.1 (24 to 74 year old). Twenty two cases revealed normal study (non-organic causes as 37.3%), 29 were classified as venous leakage, and eight of them demonstrate arterial insufficiency in the study. A flaccid state PSV of 10.5 cm/s as cut off had a sensitivity of 93.8%, specifity of 91.3% and negative predictive value of 93.8% to predict arterial disease.

Conclusion: A flaccid state PSV of 10.5 has a suitable statistical value to proclaim arterial insufficiency in cavernosal arteries in patients with erectile dysfunction as a complaint.