MORPHODYNAMIC ASSESSMENT OF PENILE CIRCULATION IN IMPOTENT PATIENTS -THE ROLE OF DUPLEX AND COLOR DOPPLER SONOGRAPHY

Duplex and color Doppler sonography were used to assess the vascular s tatus of 240 impotent patients.The tests were performed before and aft er intracorporal injection of a standard dose of a vasoactive mixture and measurements were done both at the crura and at the midshaft of th e penis. Particular care was taken in the evaluation of cavernosal art eries diameter, wall pulsatility, morphology of spectral waveform, blo od flow acceleration, systolic and diastolic flow velocity and flow vo lume. Resistance and pulsatility indexes of the cavernosal arteries we re also measured. Flow along the deep dorsal vein was quantified when possible. Cavernosal artery peak systolic flow velocity, flow volume a nd acceleration were the best indicators of arterial penile circulatio n. Persistently elevated (> 10 cm/s) diastolic flow in the cavernosal arteries positively correlated with a diagnosis of venogenic impotence obtained by dynamic infusion cavernosometry-cavernosography in almost 80% of cases. Duplex and color Doppler sonography permit to thoroughl y evaluate cavernosal arteries function and seem to have a promising r ole in the study of the veno-occlusive mechanism of the corpora cavern osa.