Data 1

INTRACAVERNOUS INJECTION OF PHENTOLAMINE DURING COLOR DOPPLER ULTRASOUND (CDUS) CAN ABOLISH APPARENT VENOUS LEAKAGE IN YOUNG PATIENTS WITH SYMPATHETIC OVERACTIVITY Dynamic CDUS diagnosis of venogenic impotence in young patients may be misleading. Some men with either anxiety or increased sympathetic tone may not respond to the vasoactive intracavernous injection. Although one would expect good results from young men with primary venous impotence treated by surgery, clinical studies in this area are disappointing. There is little standardisation of the technique of dynamic CDUS and our hypothesis was that men with a primary sympathetic inhibition of the erectile response might be being misdiagnosed as suffering from a venous leak. The objective of this study was to evaluate the CDUS parameters and objective erectile response in young men in whom a diagnosis of venous leakage might have been made on the basis of a CDUS study using PGE1 alone. Dynamic CDUS was performed on 28 young patients (Their mean (and median) age was 28 years 95% C I 26, 30). Five older men (mean age was 55.4) were also studied. With only PGE1 injection, 21 of them had been classified to have venogenic impotence as defined by the presence of an end diastolic velocity (EDV) > 5 cm/s when the peak systolic velocity (PSV) was at least 35 cm/s with a suboptimal erection. These patients were then given 2mg of phentolamine. The diameter, PSV, EDV and clinical response were studied.. Compared to baseline, the first 10 mg of prostaglandin yielded a significant increase in diameter and PSV for 20 patients (p=0.0001). The dose increase in prostaglandin, from 10 mg to 20 mg, brought up a still significant increase in diameter (p=0.02) PSV (0.02) and grade (p=0.001). Phentolamine 2mg brought up a highly significant increase in grade, resistive index (RI) and a significant decrease in EDV compared to prostaglandin (p=0.0001). In 20 of the 21 patients the EDV was < 5cms/sec and in 16 of them there was flow reversal. The only patient who did not have EDV falling to <5cms/sec, with phentolamine had a cavernosogram, which revealed an anatomical venous leak. In the older group of 5 patients there was significant increase in PSV with 10 and 20 mcg of prostaglandin compared to the base line values (p=,…) but the rise in EDV (>5 cms/sec) did not decrease, nor there was any flow reversal with phentolamine (p=…). Their grade was suboptimal. In conclusion, CDUS with phentolamine is mandatory prior to patients ebing considered for vascular surgery for ED. Copyright (c) 1999-2001 GH Muir. All rights reserved. [email protected]

INTRACAVERNOUS INJECTION OF PHENTOLAMINE DURING COLOR DOPPLER ULTRASOUND (CDUS) CAN ABOLISH APPARENT VENOUS LEAKAGE IN YOUNG PATIENTS WITH SYMPATHETIC OVERACTIVITY

Dynamic CDUS diagnosis of venogenic impotence in young patients may be misleading. Some men with either anxiety or increased sympathetic tone may not respond to the vasoactive intracavernous injection. Although one would expect good results from young men with primary venous impotence treated by surgery, clinical studies in this area are disappointing. There is little standardisation of the technique of dynamic CDUS and our hypothesis was that men with a primary sympathetic inhibition of the erectile response might be being misdiagnosed as suffering from a venous leak. The objective of this study was to evaluate the CDUS parameters and objective erectile response in young men in whom a diagnosis of venous leakage might have been made on the basis of a CDUS study using PGE1 alone. Dynamic CDUS was performed on 28 young patients (Their mean (and median) age was 28 years 95% C I 26, 30). Five older men (mean age was 55.4) were also studied. With only PGE1 injection, 21 of them had been classified to have venogenic impotence as defined by the presence of an end diastolic velocity (EDV) > 5 cm/s when the peak systolic velocity (PSV) was at least 35 cm/s with a suboptimal erection. These patients were then given 2mg of phentolamine. The diameter, PSV, EDV and clinical response were studied.. Compared to baseline, the first 10 mg of prostaglandin yielded a significant increase in diameter and PSV for 20 patients (p=0.0001). The dose increase in prostaglandin, from 10 mg to 20 mg, brought up a still significant increase in diameter (p=0.02) PSV (0.02) and grade (p=0.001). Phentolamine 2mg brought up a highly significant increase in grade, resistive index (RI) and a significant decrease in EDV compared to prostaglandin (p=0.0001). In 20 of the 21 patients the EDV was < 5cms/sec and in 16 of them there was flow reversal. The only patient who did not have EDV falling to <5cms/sec, with phentolamine had a cavernosogram, which revealed an anatomical venous leak. In the older group of 5 patients there was significant increase in PSV with 10 and 20 mcg of prostaglandin compared to the base line values (p=,…) but the rise in EDV (>5 cms/sec) did not decrease, nor there was any flow reversal with phentolamine (p=…). Their grade was suboptimal. In conclusion, CDUS with phentolamine is mandatory prior to patients ebing considered for vascular surgery for ED.

INTRACAVERNOUS INJECTION OF PHENTOLAMINE DURING COLOR DOPPLER ULTRASOUND (CDUS) CAN ABOLISH APPARENT VENOUS LEAKAGE IN YOUNG PATIENTS WITH SYMPATHETIC OVERACTIVITY

Dynamic CDUS diagnosis of venogenic impotence in young patients may be misleading. Some men with either anxiety or increased sympathetic tone may not respond to the vasoactive intracavernous injection. Although one would expect good results from young men with primary venous impotence treated by surgery, clinical studies in this area are disappointing. There is little standardisation of the technique of dynamic CDUS and our hypothesis was that men with a primary sympathetic inhibition of the erectile response might be being misdiagnosed as suffering from a venous leak. The objective of this study was to evaluate the CDUS parameters and objective erectile response in young men in whom a diagnosis of venous leakage might have been made on the basis of a CDUS study using PGE1 alone. Dynamic CDUS was performed on 28 young patients (Their mean (and median) age was 28 years 95% C I 26, 30). Five older men (mean age was 55.4) were also studied. With only PGE1 injection, 21 of them had been classified to have venogenic impotence as defined by the presence of an end diastolic velocity (EDV) > 5 cm/s when the peak systolic velocity (PSV) was at least 35 cm/s with a suboptimal erection. These patients were then given 2mg of phentolamine. The diameter, PSV, EDV and clinical response were studied.. Compared to baseline, the first 10 mg of prostaglandin yielded a significant increase in diameter and PSV for 20 patients (p=0.0001). The dose increase in prostaglandin, from 10 mg to 20 mg, brought up a still significant increase in diameter (p=0.02) PSV (0.02) and grade (p=0.001). Phentolamine 2mg brought up a highly significant increase in grade, resistive index (RI) and a significant decrease in EDV compared to prostaglandin (p=0.0001). In 20 of the 21 patients the EDV was < 5cms/sec and in 16 of them there was flow reversal. The only patient who did not have EDV falling to <5cms/sec, with phentolamine had a cavernosogram, which revealed an anatomical venous leak. In the older group of 5 patients there was significant increase in PSV with 10 and 20 mcg of prostaglandin compared to the base line values (p=,…) but the rise in EDV (>5 cms/sec) did not decrease, nor there was any flow reversal with phentolamine (p=…). Their grade was suboptimal. In conclusion, CDUS with phentolamine is mandatory prior to patients ebing considered for vascular surgery for ED.

Dynamic CDUS diagnosis of venogenic impotence in young patients may be misleading. Some men with either anxiety or increased sympathetic tone may not respond to the vasoactive intracavernous injection. Although one would expect good results from young men with primary venous impotence treated by surgery, clinical studies in this area are disappointing. There is little standardisation of the technique of dynamic CDUS and our hypothesis was that men with a primary sympathetic inhibition of the erectile response might be being misdiagnosed as suffering from a venous leak. The objective of this study was to evaluate the CDUS parameters and objective erectile response in young men in whom a diagnosis of venous leakage might have been made on the basis of a CDUS study using PGE1 alone.

Dynamic CDUS was performed on 28 young patients (Their mean (and median) age was 28 years 95% C I 26, 30). Five older men (mean age was 55.4) were also studied. With only PGE1 injection, 21 of them had been classified to have venogenic impotence as defined by the presence of an end diastolic velocity (EDV) > 5 cm/s when the peak systolic velocity (PSV) was at least 35 cm/s with a suboptimal erection. These patients were then given 2mg of phentolamine. The diameter, PSV, EDV and clinical response were studied.. Compared to baseline, the first 10 mg of prostaglandin yielded a significant increase in diameter and PSV for 20 patients (p=0.0001). The dose increase in prostaglandin, from 10 mg to 20 mg, brought up a still significant increase in diameter (p=0.02) PSV (0.02) and grade (p=0.001). Phentolamine 2mg brought up a highly significant increase in grade, resistive index (RI) and a significant decrease in EDV compared to prostaglandin (p=0.0001). In 20 of the 21 patients the EDV was < 5cms/sec and in 16 of them there was flow reversal. The only patient who did not have EDV falling to <5cms/sec, with phentolamine had a cavernosogram, which revealed an anatomical venous leak. In the older group of 5 patients there was significant increase in PSV with 10 and 20 mcg of prostaglandin compared to the base line values (p=,…) but the rise in EDV (>5 cms/sec) did not decrease, nor there was any flow reversal with phentolamine (p=…). Their grade was suboptimal.

In conclusion, CDUS with phentolamine is mandatory prior to patients ebing considered for vascular surgery for ED.

Copyright (c) 1999-2001 GH Muir. All rights reserved.
[email protected]