Abnormal Penile Doppler in Erectile dysfunction, spectral Doppler, oral sildenafil

The Penile Doppler ultrasound findings in this patient, who has a history of smoking and alcoholism, indicate vasculogenic erectile dysfunction. Before taking 100 mg of sildenafil, the cavernosal artery diameter was 0.7 mm, which increased to 1.5 mm after 30 minutes, suggesting some arterial dilation. However, the peak systolic velocity (PSV) was only 17 cm/s at 30 minutes and 20 cm/s at 40 minutes, both below the normal threshold of 30 cm/s, indicating arterial insufficiency. The resistive index (RI) was 0.8, slightly below the normal post-sildenafil value of greater than 0.9, suggesting incomplete venous occlusion. Initially, the end-diastolic velocity (EDV) was 2.8 cm/s, indicating persistent venous outflow, but it dropped to 0 cm/s after 40 minutes, reflecting delayed venous occlusion. These findings, influenced by the patient's smoking and alcohol history, suggest a combination of arterial insufficiency and venous leak, contributing to his erectile dysfunction. Further evaluation and lifestyle changes are recommended to improve vascular health and erectile function.

#ultrasound
#Penile Doppler
#erectile dysfunction