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Zhang Y, Wu X, Feng X, Liu G, Jiang H, Zhang X. A novel strategy to induce penile erection during penile doppler ultrasound: oral sildenafil administration plus alprostadil injection. Aging Male 2024; 27:2339352. [PMID: 38590113 DOI: 10.1080/13685538.2024.2339352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/01/2024] [Indexed: 04/10/2024] Open
Abstract
OBJECTIVES To evaluate the efficacy of a novel approach to achieve the optimal penile erection during the penile doppler ultrasound (PDU) examination, which was oral sildenafil combined alprostadil injection. MATERIALS AND METHODS A total of 60 ED patients were enrolled in our prospective study, and they were randomly assigned to two group with different PDU order. The approaches assisted the PDU included two models, mode A meaning injection of 15 μg alprostadil and model B meaning oral sildenafil 100 mg plus injection of 15 μg alprostadil. The PDU parameters were measured continuously before induced erection, and 5, 10, 15, 20, 25 min. RESULTS Each group included 30 ED patients with similar clinical characteristics. After pooling the results together, the PSV, EDV, and RI were all improved significantly, when adding the oral sildenafil administration to assist PDU. Also, the clinical response of oral sildenafil administration plus alprostadil injection was better than that in alprostadil injection alone (p = 0.016). The arterial ED were decreased from 31.67% to 15.00% with the P value 0.031, and the mixed ED was also decreased statistically (23.33% vs 8.33%, p = 0.024). CONCLUSION Oral sildenafil administration plus alprostadil injection could improve the diagnostic accuracy of PDU.
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Affiliation(s)
- Yuyang Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, China
| | - Xu Wu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, China
| | - Xingliang Feng
- Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
- The First People's Hospital of Changzhou, Changzhou, Jiangsu, China
| | - Guodong Liu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, China
| | - Hui Jiang
- Department of Urology, Peking University First Hospital Institute of Urology, Peking University Andrology Center, Beijing, China
| | - Xiansheng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, China
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Wang M, Dai Y, Jiang H, Sansone A, Jannini EA, Zhang X. Application of dual-energy CT angiography in diagnosis of arterial erectile dysfunction: new scanning technology, new scanning area. Aging Male 2022; 25:257-265. [PMID: 36102620 DOI: 10.1080/13685538.2022.2121815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVES To explore the value of dual-energy computed tomography (DE-CT) angiography in diagnosis of arteriogenic erectile dysfunction (ED) patients and feasibility of new scanning area that excludes the testis. MATERIALS AND METHODS Ninety-three patients suspected of suffering arterial ED and 40 health volunteers underwent penile duplex Doppler ultrasound and DE-CT angiography (DE-CTA). The scanning range of DE-CTA covered whole arterial system of pelvis and testis was excluded. Two blinded investigators independently evaluated the arterial system that supplies the penis. RESULTS Finally, 1596 segments were evaluated and 470 segments were judged to be abnormal. The distribution was: 2 (0.4%) in common iliac artery, 7 (1.5%) in internal iliac artery, 82 (17.5%) in internal pudendal artery, 89 (18.9%) in penile artery, 120 (25.5%) in dorsal artery, and 170 (36.2%) in cavernosal artery. The specificity, sensitivity, positive predictive value, and negative predictive value of DE-CTA in diagnostic were 86.02%, 87.50%, 94.12%, and 72.92%. Besides, the new scan area allowed for effective evaluation of the arteries while excluding the testis. CONCLUSION DE-CTA can provide unbiased, safe evaluation of the vascular status of the penile bed in patients with ED.
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Affiliation(s)
- Ming Wang
- Department of Urology, First affiliated hospital of Anhui medical university, Hefei, China
| | - Yutian Dai
- Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Hui Jiang
- Department of Andrology, Peking University Third Hospital, Beijing, China
| | - Andrea Sansone
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Emmanuele A Jannini
- Chair of Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Xiansheng Zhang
- Department of Urology, First affiliated hospital of Anhui medical university, Hefei, China
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Chavarriaga J, Prada J, Olejua P, López-Ramos H, Manjarrez M, Silva JM. Complete study for erectile dysfunction (CompED) improving diagnosis and treatment decision-making. Andrologia 2021; 53:e14212. [PMID: 34374105 DOI: 10.1111/and.14212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/12/2021] [Accepted: 07/27/2021] [Indexed: 01/27/2023] Open
Abstract
Erectile dysfunction is a condition associated with increasing age. Patient evaluation and management should follow a comprehensive, stepwise approach. The aim of this article was to report our experience with the complete study for erectile dysfunction, including intracavernous injection rigidity test, biothesiometry and colour duplex Doppler ultrasound. Data were collected and analysed prospectively. The primary end point was to determine whether treatment decision-making was eased by the CompED test. Secondary end points were to establish which clinical variables prior to the study could impact the results of the CompED test, to finally improve patient selection for the study. 187 patients were recruited, 31.2% of the patients had an axial rigidity below 50%, 28.5% had a peak systolic velocity <25 cm/s, 13.2% had an end-diastolic velocity >5cm/s and 27.5% had an abnormal biothesiometry. The factors that best predicted an abnormal result in any of the tests were age >70 years, IIEF domain A < 14 points, and previous radical prostatectomy or radiotherapy. The CompED test stands as a new alternative for the evaluation of patients with erectile dysfunction, being less time consuming, aiding in a more accurate determination of the aetiology and guiding treatment decision-making.
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Affiliation(s)
- Julian Chavarriaga
- Division of Urology, Hospital Universitario San Ignacio. Pontificia Universidad Javeriana, Bogotá, Colombia.,Division of Urology, Clínica Imbanaco - Quiron Salud, Cali, Colombia
| | - Juan Prada
- Division of Urology, Hospital Universitario San Ignacio. Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Peter Olejua
- Department of Epidemiology and Biostatistics. Hospital, Universitario San Ignacio. Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Hugo López-Ramos
- Division of Urology, Hospital Universitario San Ignacio. Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Maryori Manjarrez
- Division of Urology, Hospital Universitario San Ignacio. Pontificia Universidad Javeriana, Bogotá, Colombia
| | - José-Miguel Silva
- Division of Urology, Hospital Universitario San Ignacio. Pontificia Universidad Javeriana, Bogotá, Colombia
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The Efficacy of Penile Duplex Ultrasound in Erectile Dysfunction Management Decision-Making: A Systematic Review. Sex Med Rev 2021; 9:472-477. [DOI: 10.1016/j.sxmr.2020.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/17/2020] [Accepted: 10/25/2020] [Indexed: 12/27/2022]
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Zhang Y, Zhou W, Wu X, Liu G, Dai Y, Jiang H, Zhang X. Cavernous artery intima-media thickness predicts the response to sildenafil in erectile dysfunction patients as a morphological parameter. Andrologia 2021; 53:e14149. [PMID: 34151474 DOI: 10.1111/and.14149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/18/2021] [Accepted: 05/31/2021] [Indexed: 11/29/2022] Open
Abstract
While the intima-media thickness (IMT) of the cavernous artery was used for diagnosis for vascular erectile dysfunction (ED) with more accuracy than the peak systolic velocity, the role of the IMT in predicting treatment responses remained unexamined. A total of 136 patients with ED were enrolled. The baseline clinical and laboratory characteristics were collected. Penile Doppler ultrasonography (PDU) was performed on all patients by a blinded sonographer. Sildenafil was administrated to all patients with an adjusted dose of 50 or 100 mg on demand over a period of 3 months. A follow-up was conducted on all patients using the Erectile Hardness Score (EHS) questionnaire along with the visual and tactile version of the standardised EHS tool. The peak systolic velocity (PSV) and IMT were compared between sildenafil responders and sildenafil nonresponders, while receiver operator characteristic (ROC) curves were used to calculate the cut-off values and compare the test power respectively. There was no statistical difference from the baseline characteristics. The IMT of cavernous artery was more accurate than PSV to predict the sildenafil response (AUC = 0.809, 0.626 respectively). IMT could predict sildenafil responders more accurately than PSV, and the cut-off value of the IMT of the cavernous artery was less than 0.22 mm.
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Affiliation(s)
- Yuyang Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Wang Zhou
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xu Wu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Guodong Liu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
| | - Yutian Dai
- Department of Andrology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Hui Jiang
- The department of Urology, Peking University Third Hospital, Beijing, China
| | - Xiansheng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, China
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Kamal EE, Ali MEM, Mohamed MZ, Soliman M, El-Mahdy RI, Elsayed A, Badran AY. Relation of pharmacopenile duplex ultrasonography parameters and glycated hemoglobin (HbA1c) in diabetic patients with erectile dysfunction. Rev Int Androl 2020; 20:31-40. [PMID: 33334711 DOI: 10.1016/j.androl.2020.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 04/22/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND OBJECTIVES Erectile dysfunction (ED) is one of the main threats in diabetic patients. This research aimed to assess the relationship between glycated hemoglobin (HbA1c) level and pharmacopenile duplex ultrasonography (PPDU) indices in diabetic patients with ED. MATERIALS AND METHODS A total of 130 males with ED were recruited (100 had diabetes mellitus (DM) and 30 did not as control). The International Index of Erectile Function (IIEF) was used to evaluate patients for ED. Measurement of HbA1c, lipid profile and assessment of erectile function using PPDU were performed. All participants were assessed to take the medical history. RESULTS The mean age±SD was 53.8±8.9 and 53.6±2.8 years for patients and controls, respectively. Patients had variable grades of ED: mild in 20%, mild to moderate in 32.3%, moderate in 35.3%, and severe in 12.3%. A significant association was found between the existence of DM and a deprived response to intracorporeal injection (ICI), rising end-diastolic velocity (EDV), and reducing resistance index (RI) values. Comparing all diabetic groups according to HbA1c with controls, a significant relationship was found in; severity of IIEF-5 score, poor response to ICI, decreased peak systolic velocity (PSV) at 10min, increased EDV at 10, 20min and decreased RI at 10, 20min. A significant relationship was found between smoking, dyslipidaemia, and decreased PSV at 10, 20min and decreased increment ratio. However, a non-significant relationship was observed between age, type of DM and PPDU parameters. CONCLUSION Poor glycaemic control of DM is associated with an increase in EDV and decrease in RI, and PSV of PPDU.
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Affiliation(s)
- Emad Eldien Kamal
- Department of Dermatology and Andrology, Faculty of Medicine, Assiut University, Egypt
| | - Mohammed Essam M Ali
- Department of Dermatology and Andrology, Faculty of Medicine, Assiut University, Egypt
| | | | - Mona Soliman
- Department of Internal medicine and endocrinology, Faculty of Medicine, Assiut University, Egypt
| | - Reham I El-Mahdy
- Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Egypt.
| | - Ahmed Elsayed
- Department of Dermatology and Andrology, Faculty of Medicine, Assiut University, Egypt
| | - Aya Y Badran
- Department of Dermatology and Andrology, Faculty of Medicine, Assiut University, Egypt
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Palmieri A, Arcaniolo D, Palumbo F, Verze P, Liguori G, Mondaini N, Falcone M, Scroppo FI, Salonia A, Cai T. Low intensity shockwave therapy in combination with phosphodiesterase-5 inhibitors is an effective and safe treatment option in patients with vasculogenic ED who are PDE5i non-responders: a multicenter single-arm clinical trial. Int J Impot Res 2020; 33:634-640. [PMID: 32683417 DOI: 10.1038/s41443-020-0332-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 06/20/2020] [Accepted: 07/09/2020] [Indexed: 12/25/2022]
Abstract
Low-intensity shockwave therapy (Li-ESWT) has been shown to be an effective and safe treatment for vasculogenic erectile dysfunction (ED). We aim to evaluate the effectiveness and safety of LiESWT in treating patients affected from vasculogenic ED who did not respond to oral treatment with Phosphodiesterase 5 inhibitors (PDE5-i). It is a multicentric open-label prospective study, in a cohort of patients non-responders to PDE-5i. Li-ESWT was performed in an outpatient setting by using the following schedule: 3000 shockwaves with an energy of 0.25 mJ/mm2 and a frequency of 4-6 Hz, twice a week for 3 weeks. International Index of Erectile Function, Erection Hardness Score and Sexual Quality of Life-Male questionnaires, and penile doppler ultrasound (PDU) are the outcome measurements. The Student t-test or Wilcoxon signed-rank test were applied to compare variables, with results considered statistically significant at p < 0.05. 106 (97.2%) completed treatment and performed follow-up visit after 4 weeks. At follow up visit, the mean IIEF-EF increased by 8.6 points (13.47 ± 4.61 vs 22.07 ± 5.27; p < 0.0001). A clinically significant improvement of IIEF-EF was achieved in 75 patients (70.7%). An EHS score ≥ 3, sufficient for a full intercourse, was reported by 72 patients (67.9%) at follow-up visit. 37 (34.9%) patients reported a full rigid penis (EHS = 4) after treatment. Li-ESWT treatment was also able to improve quality of life (SQOL-M: 45.56 ± 8.00 vs 55.31 ± 9.56; p < 0.0001). Li-ESWT significantly increased mean PSV (27.79 ± 5.50 vs 41.66 ± 8.59; p < 0.0001) and decreased mean EDV (5.66 ± 2.03 vs 1.93 ± 2.11; p < 0.0001) in PDU. Combination of Li-ESWT and PDE5-i represents an effective and safe treatment for patients affected from ED who do not respond to first line oral therapy.
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Affiliation(s)
| | | | | | - Paolo Verze
- Department of Urology, University Federico II, Naples, Italy
| | | | - Nicola Mondaini
- Urology Unit, Nuovo San Giovanni di Dio Hospital, Florence, Italy
| | - Marco Falcone
- Department of Urology, University of Turin, Turin, Italy
| | | | - Andrea Salonia
- Department of Urology, University Vita e Salute, San Raffaele, Milan, Italy
| | - Tommaso Cai
- Department of Urology, Santa Chiara Regional Hospital, Trento, Italy.
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Morgado A, Diniz P, Silva CM. Is There a Point to Performing a Penile Duplex Ultrasound? J Sex Med 2019; 16:1574-1580. [DOI: 10.1016/j.jsxm.2019.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 07/05/2019] [Accepted: 07/12/2019] [Indexed: 01/31/2023]
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9
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Chen L, Xu L, Wang J, Li H, Zhang D, Zhang C, Jia H, Xie M, Zhu Z, Yang Y. Diagnostic Accuracy of Different Criteria of Pharmaco-penile Duplex Sonography for Venous Erectile Dysfunction. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:2739-2748. [PMID: 30839126 PMCID: PMC6849731 DOI: 10.1002/jum.14982] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 02/01/2019] [Accepted: 02/04/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES The aim of this study was to analyze the diagnostic accuracy of different criteria of pharmaco-penile duplex sonography in venous erectile dysfunction (ED). METHODS The following parameters were measured after an intracavernous injection test in patients with ED from May 2016 to February 2017 at our hospital: diameter, peak systolic velocity, end-diastolic velocity, and resistance index of the cavernous artery; diameter and peak velocity (if leak occurred) of the deep dorsal vein. Three ultrasonographic diagnostic criteria of venous ED were applied. Criterion A: continuous blood flow signals in the deep dorsal vein, peak velocity greater than 3 cm/s, peak systolic velocity greater than 30 cm/s, end-diastolic velocity greater than 5 cm/s; Criterion B: resistance index less than 0.89 and other parameters corresponding with Criterion A; Criterion C: resistance index less than 0.80 and other parameters corresponding with Criterion A. The diagnostic results of each criterion were compared with the cavernosographic results. RESULTS Thirty-six patients were diagnosed as venous ED by cavernosography in 54 ED cases. The diagnostic specificity, sensitivity, and accuracy of Criterion A were 70.6%, 91.7%, and 84.9%, respectively. Those of Criterion B were 82.4%, 69.4%, and 73.6%, while the results for Criterion C were 94.1%, 33.3%, and 52.8%, respectively. Criterion A had the highest diagnostic accuracy, the largest area under the receiver operating characteristic curve (area = 0.811), and the highest consistency (kappa = 0.642) with the cavernosographic results in the 3 criteria. The difference was statistically significant (P < .05). CONCLUSIONS Among the 3 commonly used ultrasonographic criteria, Criterion A is most appropriate in the diagnosis of venous ED.
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Affiliation(s)
- Li Chen
- Department of UltrasoundUnion Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Department of UltrasoundThe First People's Hospital of YibinSichuanChina
| | - Lingling Xu
- Department of UltrasoundUnion Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Hubei Province Key Laboratory of Molecular ImagingWuhanChina
| | - Jin Wang
- Department of Urology Surgery, West Campus, Union HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
| | - Hong Li
- Department of UltrasoundUnion Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Hubei Province Key Laboratory of Molecular ImagingWuhanChina
| | - Danqing Zhang
- Department of UltrasoundUnion Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Hubei Province Key Laboratory of Molecular ImagingWuhanChina
| | - Cuihong Zhang
- Department of UltrasoundUnion Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Hubei Province Key Laboratory of Molecular ImagingWuhanChina
| | - Huijun Jia
- Department of UltrasoundUnion Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Hubei Province Key Laboratory of Molecular ImagingWuhanChina
| | - Mingxing Xie
- Department of UltrasoundUnion Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Hubei Province Key Laboratory of Molecular ImagingWuhanChina
| | - Zhaohui Zhu
- Department of Urology Surgery, West Campus, Union HospitalTongji Medical College, Huazhong University of Science and TechnologyWuhanChina
| | - Yali Yang
- Department of UltrasoundUnion Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhanChina
- Hubei Province Key Laboratory of Molecular ImagingWuhanChina
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Morgado A, Dinis P, Silva CM. Is there a role for bilateral peak systolic velocity readings in a penile duplex ultrasound? Andrologia 2019; 51:e13297. [DOI: 10.1111/and.13297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 03/13/2019] [Accepted: 03/25/2019] [Indexed: 11/30/2022] Open
Affiliation(s)
- Afonso Morgado
- Serviço de Urologia Centro Hospitalar São João Porto Portugal
- Departamento de Biomedicina Faculdade de Medicina da Universidade do Porto Porto Portugal
| | - Paulo Dinis
- Serviço de Urologia Centro Hospitalar São João Porto Portugal
- Departamento de Cirurgia e Fisiologia Faculdade de Medicina da Universidade do Porto Porto Portugal
| | - Carlos Martins Silva
- Serviço de Urologia Centro Hospitalar São João Porto Portugal
- Departamento de Cirurgia e Fisiologia Faculdade de Medicina da Universidade do Porto Porto Portugal
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Differences in Cavernosal Artery Parameters According to Different Anatomic Sampling Locations During the Diagnosis of Vascular Erectile Dysfunction Using Duplex Ultrasound. Urology 2017; 105:33-41. [PMID: 28392182 DOI: 10.1016/j.urology.2017.01.057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 01/27/2017] [Accepted: 01/31/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To establish a standard location for examining penile cavernosal arteries (CAs) using dynamic duplex Doppler ultrasound (PDDU) examination in the diagnosis of non-arterial erectile dysfunction (ED) or arterial insufficiency. PATIENTS AND METHODS Two groups of 105 patients each were enrolled. The first group (age 56.3 ± 6.0 years) displayed clinical patterns of arterial insufficiency; the second group (age 35.2 ± 4.7 years) displayed clinical patterns of non-arterial ED. The patients had their peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI = PSV - EDV/PSV × 100), and acceleration time of the CAs measured using PDDU at the crura and at the midpoint between the penoscrotal junction and the coronal sulcus (mid penis). Intra- and interoperator variability were assessed. The PSV, RI, acceleration time, and EDV data obtained from the penoscrotal junction or from the "mid penis" in group 1 and in group 2 were compared using analysis of variance. RESULTS The PSV, EDV, and acceleration time were significantly higher when measured at the crura penis than when measured at the "mid penis" in both groups, whereas the RI was higher at the "mid penis" than at the "crura." Thus, arterial ED was better diagnosed with the data from the mid penis, whereas non-arterial ED was better diagnosed at the "crura." CONCLUSION The location of the sampling site of the CAs using PDDU is critical for a correct diagnosis of ED.
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Cavallini G, Scroppo FI, Zucchi A. Peak systolic velocity thresholds of cavernosal penile arteries in patients with and without risk factors for arterial erectile deficiency. Andrology 2016; 4:1187-1192. [DOI: 10.1111/andr.12242] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 05/22/2016] [Accepted: 05/24/2016] [Indexed: 11/30/2022]
Affiliation(s)
- G. Cavallini
- Gynepro Medical Team; Andrological Operative Unit; Bologna Italy
| | - F. I. Scroppo
- Operative Unit of Urology; Section of Andrology; Hospital of Varese - Macchi Foundation; Varese Italy
| | - A. Zucchi
- Urology and Andrology Department; Perugia School of Medicine; Santa Maria della Misericordia Hospital - S. Andrea delle Fratte Hospital; Perugia Italy
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