Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Research
  • Published:

Congruence between veno-occlusive parameters during dynamic infusion cavernosometry: assessing the need for cavernosography

Abstract

While dynamic infusion cavernosometry (DIC) is being performed with increasing rarity, some centers continue to use this investigation modality. Cavernosography may be utilized to identify the location of patent venous channels in men with venous leak. In an era when venous ligation surgery is being performed with less frequency, the role of cavernosography has been questioned. This study was conducted to define the congruence between the three parameters (flow-to-maintain (FTM), pressure decay (PD) and cavernosography) used in the diagnosis of venous leak during DIC. Established values for the three parameters were utilized and the diagnosis of venous leak was based upon the FTM measurement. All studies were performed using a vasoactive agent-redosing schedule. Cavernosography was conducted using a nonionic contrast agent at an intracorporal pressure of 90 mmHg. In patients with an elevated FTM value, 24% had a normal PD recorded, all of whom had FTM values <10 ml/min. The Pearson correlation coefficient for the relationship between FTM and PD was 0.58 (P=0.025). In all, 36 patients (54%) had an abnormal cavernosogram (CG). All patients who had positive findings on CG had elevated FTM values. On the other hand, 46% of patients with abnormal FTM values had a normal CG. This analysis indicates that almost one-half of men with venous leak diagnosed at the time of DIC based on FTM measurement will fail to have any veins visualized on cavernosography. These data further undermine the value of cavernosography, particularly in men with low-grade venous leak.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Broderick GA, Arger P . Duplex Doppler ultrasonography: noninvasive assessment of penile anatomy function. Semin Roentgenol 1993; 28: 43.

    Article  CAS  Google Scholar 

  2. Quam JP et al. Duplex color Doppler sonographic evaluation of vasculogenic impotence. Am J Roentgenol 1989; 153: 1141.

    Article  CAS  Google Scholar 

  3. Karadeniz T et al. Judgment of color Doppler ultrasound with respect to cavernous artery occlusion pressure in dynamic infusion cavernosometry when evaluating arteriogenic impotence. Urol Int 1996; 57: 85.

    Article  CAS  Google Scholar 

  4. Karadeniz T et al. Value of color Doppler sonography in the diagnosis of venous impotence. Urol Int 1995; 55: 1.

    Article  Google Scholar 

  5. Motiwala HG . Dynamic pharmacocavernosometry: a search for an ideal approach. Urol Int 1993; 51: 1.

    Article  CAS  Google Scholar 

  6. Velkova K, Shopov A, Dichev B . Radiologic methods used in the diagnostics of vasculogenic erectile dysfunction. Folia Med 1992; 34: 33.

    CAS  Google Scholar 

  7. Kayigil O, Atahan O, Metin A . Dynamic infusion cavernosometry cavernosography in diagnosing classifying venoocclusive dysfunctionInt. Urol Nephrol 1995; 27: 615.

    Article  CAS  Google Scholar 

  8. Mulhall JP, Abdel-Moneim A, Abobakr R, Goldstein I . Improving the accuracy of vascular testing of the impotent male: correction of hemodynamic alterations using a vasoactive medication redosing schedule. J Urol 2001; 166: 9232.

    Article  Google Scholar 

  9. Fehr JL et al. Significance of cavernosography in standardized cavernosometry. Urol Int 1992; 49: 13.

    Article  CAS  Google Scholar 

  10. Chen KK et al. Dynamic infusion cavernosometry cavernosography (DICC) in the evaluation of vasculogenic impotence. Chung Hua I Hsueh Tsa Chih (Taipei) 1996; 57: 266.

    CAS  Google Scholar 

  11. Lue TF . Penile venous surgery. Urol Clin North Am 1989; 16: 607.

    CAS  PubMed  Google Scholar 

  12. Puech-Leao P . Venous surgery in erectile dysfunction. Urol Int 1992; 49: 29.

    Article  CAS  Google Scholar 

  13. Lue TF . Surgery for crural venous leakage. Urology 1999; 54: 739.

    Article  CAS  Google Scholar 

  14. Rogers RS, Lue TF . Penile venous surgery benefits patients under years of age. J Urol 1999; 161: 258.

    Article  Google Scholar 

  15. Berardinucci D et al. Surgical treatment of penile veno-occlusive dysfunction: is it justified? Urology 47; 88: 1996.

    Google Scholar 

  16. Goldstein I, Krane RJ, Greenfield AJ, Padma-Nathan H . Vascular diseases of the penis: impotence priapism. In: Pollack HM (ed). Clinical Urography. WB Saunders: Philadelphia, 1990.

    Google Scholar 

  17. de Meyer JM, Thibo P . The effect of re-dosing of vasodilators on the intracavernosal pressure on the penile rigidity. Eur Urol 1998; 33: 293.

    Article  CAS  Google Scholar 

  18. Pescatori ES et al. Audiovisual sexual stimulation by virtual glasses is effective in inducing complete cavernosal smooth muscle relaxation: a pharmacocavernosometric study. Int J Impot Res 2000; 12: 83.

    Article  CAS  Google Scholar 

  19. Mulhall JP, Damaser MS . Development of a mathematical model for the prediction of the area of venous leakage. IJIR 2001; 13: 236.

    CAS  Google Scholar 

  20. Hatzichristou DG et al. In vivo assessment of trabecular smooth muscle tone its application in pharmaco-cavernosometry analysis of intracavernous pressure determinants. J Urol 1995; 153: 1126.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J P Mulhall.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mulhall, J., Anderson, M. & Parker, M. Congruence between veno-occlusive parameters during dynamic infusion cavernosometry: assessing the need for cavernosography. Int J Impot Res 16, 146–149 (2004). https://doi.org/10.1038/sj.ijir.3901177

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijir.3901177

Keywords

Search

Quick links