The gold standard in the diagnosis of venous impotence is cavernosomet
ry. But a less invasive and time-consuming screening test for patients
with a high probability of venous impotence is required. Therefore we
evaluated 82 men with erectile dysfunction by color Doppler sonograph
y after intracavernosal injection of 60 mg papaverine. 28 of them who
had a poor erectile response but sufficient arterial inflow were inclu
ded in this study. 6 patients who were previously found to have psycho
genic impotence formed the control group. After pharmacological stimul
ation by papaverine, all patients were examined for 20 min by color Do
ppler sonography in order to detect diastolic flow velocities in the c
avernosal arteries and erectile responses. Both groups of patients und
erwent pharmaco-cavernosometry in a blind fashion afterwards. The diag
nosis of venous impotence with color Doppler sonography was confirmed
by dynamic pharmaco-cavernosometry in 25 of 28 (89%) and 6 of 6 (100%)
subjects of the study and control groups, respectively. Statistically
, in the diagnosis of venous dysfunction, color Doppler sonography had
a sensitivity of 100%, specificity of 66.6%, accuracy rate of 91% and
a positive predictive value of 0.892. The gold standard in the diagno
sis of venous impotence is still cavernosometry, but it seems that col
or Doppler sonography may provide a sensitive assessment of penile ven
ous competence.