Screening for ischemic heart disease in patients with erectile dysfunct on: Role of penile Doppler ultrasonography

Objectives. To assess the role of measuring cavernosal artery blood flow as a screening tool for ischemic heart disease in patients with erectile dysfunction (ED). Methods. A total of 303 male patients with ED were enrolled in this study. Patients were interviewed for ED using the International Index of Erectile Function. The penile vasculature was assessed using color Doppler ultrasonography and the Digital Inflection Rigidometer. All patients were referred to a cardiologist for evaluation of ischemic heart disease (IHD). All patients underwent routine laboratory investigations, plus total testosterone and prolactin assessments. Results. Seventy-six percent of the patients had organic causes of ED. Of the 303 patients, 31.4% had different degrees of IHD. A statistically significant association was found between the presence of IHD and arteriogenic causes of ED, a poor response to intracorporal injection, poor rigidity in the Digital Inflection Rigidometer, and low peak systolic velocity (PSV) in the cavernosal arteries (P < 0.05 for each). No statistically significant association was found between the presence of IHD and increasing end-diastolic velocity values or decreasing resistive index in the cavernosal arteries (P > 0.05 for each). A statistically significant association was found between a higher grade of IHD and a decreasing PSV value (P < 0.05). Conclusions. The results of this study established that a reduced PSV of the cavernous artery is associated with IHD. Determining the PSV could be a reliable screening tool for the detection of IHD in patients with ED. (C) 2004 Elsevier Inc.