DOPPLER EVALUATION OF ERECTILE DYSFUNCTION IN DIABETIC PATIENT WITH INTRACAVERNOUSAL ALPROSTADIL (CAVERJECT®) INJECTION
Abstract
Objective: Erectile dysfunction (ED) is a common enough male problem. It is secondary to organic, psychogenic and combined causes. This study described the normal sonographic anatomy of the penis, sonographic technique for evaluation of ED and the normal phases of erection with intracavernousal injection (ICI) of alprostadil (coverject®). Patients and methods: Twenty five diabetic patients (on oral hypoglycemic drugs for at least 10 year) complaining of prolonged history (>2 years) of ED, aged 35 to 45 years, were included in this study. The treatment started with a minimal dose of 1.125 micrograms and the dosage was titrated to achieve rigid erection. Following the establishment of the effective dose, Doppler US examinations were performed. Results: 21 patients (84%) had a grade IV erectile response, the remaining 4 patients (16%)have grade III. A significant increase in peak systolic velocity between baseline and 20 µg PGE1 (p<0.001) was observed in all cases. Following ICI of Coverject there was a significant increase in grade of erection (p<0.001) and a significant reduction in the end diastolic volume (EDV) (p<0.001). A reduction of the EDV to below 5 cm s–1 was observed in all patients. Four patients with EDV <5.0 cm s–1 but >0.0 cm s–1 had poor erectile response following ICI while 21 showed persistent EDV reduction <5 cm s–1 with good rigidity. Conclusion: the important cause of ED in the diabetic patient is psycogenic factor and Intracavernous injections of Caverject are effective therapy for erectile dysfunctionReferences
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