THE PRESENCE OF ARTERIAL ANATOMICAL VARIATIONS CAN AFFECT THE RESULTSOF DUPLEX SONOGRAPHIC EVALUATION OF PENILE VESSELS IN IMPOTENT PATIENTS

Purpose: Since penile arterial communications are present in a signifi cant percentage of impotent patients, we evaluated whether peak systol ic cavernous blood velocity after intracavernous prostaglandin E1 inje ction might be different in patients with and without arterial variant s. Materials and Methods: Cavernous blood flow was assessed with echo color Doppler ultrasound before and after intracavernous injection of prostaglandin E1 in 63 impotent patients. The penile shaft was accurat ely evaluated to detect arterial anatomical variants. Clinical erectil e response was assessed by visual inspection and palpation. Results: O f 23 patients who obtained a full erection with full rigidity after pr ostaglandin E1 injection the cavernous peak blood velocities in 11 wit h penile arterial communications were significantly less than those in 12 without arterial communications. Conclusions: The generally accept ed limit of normal for cavernous peak blood flow obtained after prosta glandin E1 injection (greater than 25 to 30 cm. per second) must be in terpreted carefully because lower peak blood velocities may be found i n subjects with a full erectile response if arterial communications ar e present.