Objective: The purpose of this study was to evaluate the diagnostic usefulness of determining retrograde flow in the penile cavernosal-spongiosal communications (CSCs) with Doppler sonography.
Methods: Thirty-two consecutive men with erectile dysfunction (mean age, 40 years; range, 19-61 years) underwent penile color Doppler sonography. All patients were evaluated for flow direction in the CSCs.
Results: Eight of the 32 patients had normal Doppler sonographic findings; 8 had signs of veno-occlusive dysfunction; and 16 had arterial insufficiency. Doppler sonographic examinations of the patients with normal Doppler sonographic findings (100%) and veno-occlusive dysfunction (100%) showed a normal direction of flow in the CSCs. Thirteen of the 16 patients with arterial insufficiency had a normal direction of flow in the CSCs; however, reversal of the flow direction in the CSCs (from the urethral artery back to the cavernosal artery) was observed in the remaining 3 patients.
Conclusions: Investigating the direction of flow in the cavernosal artery, CSCs, and urethral artery is not time-consuming and may help establish an accurate diagnosis of arteriogenic impotence, especially in patients with borderline peak systolic flow velocity values.