VALUE OF COLOR DOPPLER SONOGRAPHY IN THE DIAGNOSIS OF VENOUS IMPOTENCE

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.