Penile Doppler US - Beyond ED

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Table 2: Doppler US Diagnostic Criteria for Vasculogenic Erectile Dysfunction
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Figure 22. ED in a 69-year-old man with diabetes, ischemic heart disease, and hypertension who underwent an unsuccessful trial of sildenafil treatment. (A) Longitudinal spectral Doppler US tracing image at 20 minutes shows features of arterial insufficiency. (B) Digital subtraction angiogram of the right internal iliac artery shows an occluded inferior branch (short arrow) and 80% stenosis of the superior branch (long arrow) of the internal pudendal artery. Similar findings were seen on the left side (not shown). The stenosis was treated with drug-eluting stents on both sides. (C) Axial CT image shows bilateral stents in the internal pudendal artery (arrows). (D) Longitudinal spectral Doppler US tracing image acquired 2 months after stent placement shows a normal finding with peak systolic velocity of greater than 35 cm/sec. The patient reported satisfactory erectile function. (E) Longitudinal spectral Doppler US tracing performed 6 months after stent placement shows a markedly reduced peak systolic velocity, which was persistently less than 25 cm/sec, and a parvus tardus pattern suggestive of stent occlusion or stenosis. The patient reported a return of ED similar to that at presentation. EDV = end-diastolic velocity, PSV = peak systolic velocity, RI = resistive index.
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