ECHO-DOPPLER-FLOWMETRIC ASSESSMENT OF PENILE DORSAL ARTERIES AND THEIR ROLE IN THE ERECTILE MECHANISM

Echo-doppler-flowmetric investigation is the best non-invasive techniq ue for evaluating vascular dynamics of the erection mechanism. Previou s studies were carried out with the aim of obtaining some reference pa rameters for healthy subjects and for subjects affected by impotence w ith different etiology. All of these studies focused on the penile cav ernous artery, neglecting the role played by the penile dorsal artery in the erection process. In this study we examined the flowmetric patt ern of the penile dorsal artery before and after intracavernous inject ion of PGE1 10 mu g. A significant increase in the velocity of systoli c and diastolic velocity was observed in dorsal arteries after intraca vernous injection (P < 0.0001) in control subjects and in non-arteriog enic impotent patients. Moreover, the systolic velocity of dorsal arte ries presents, after pharmacological stimulation, a statistically sign ificant difference in comparison to the homolateral cavernous artery i n non-arteriogenic impotent patients and in healthy subjects. In patie nts with arterial insufficiency, the absence of the dorsal artery was observed in 5 cases. Furthermore, the systolic velocity of dorsal arte ries turns out to be significantly lower than the systolic velocity of dorsal arteries in normal subjects; it is, however, higher than the r eference standard for arteriogenic impotent patients. II is likely tha t the penile dorsal artery, because of its extensive vascular connecti ons with the cavernous artery, provides a hemodynamic support, which c an counterbalance slight disorders of cavernous arteries. When the dor sal artery is absent (agenesis, aplasia), or diseased, even slight alt erations can result in an early onset of erectile insufficiency. (C) 1 997 Elsevier Science Ireland Ltd.