Early Onset ED and Abnormal Cavernosal Arterial Inflow
Early Onset ED and Abnormal Cavernosal Arterial Inflow
The average age of the 23 patients in this case series was 33 years (Table 1), and all complained of ED for >6 months at the time of their clinical presentation. If arterial disease is to be defined as a PSV ≤25 cm s in both cavernosal arteries, only 1 of these 23 patients (4%) met that cutoff and he was 46 years of age. One additional patient, 32 years of age, had one of the two cavernosal arteries with a PSV of 23 cm s whereas the contralateral cavernosal artery registered 33 cm s. If arterial disease, however, is defined as a PSV of ≤35 cm s in both cavernosal vessels, then 3 of the 23 (13%) meet this criterion of arteriolar disease.
Following the intracavernosal injection of a vasoactive substance, only 2 of the 23 patients failed to have a ≥50% dilatation of both of their cavernosal arteries. In one of these patients, there was normal flow in both vessels whereas in the other patient, the PSVs (cm s) were 30 and 27 in each of his cavernosal arteries. There were three other patients who demonstrated a ≤50% dilatation in one of their two cavernosal arteries and in all three of these patients, they had normal bilateral PSVs. All 23 patients, regardless of their PSV, had normal acceleration times.
Fifteen of the 23 patients underwent a DIC. Of these 15 patients, 9 demonstrated the presence of venous leakage although only one of these 9 with a positive DIC test had forward diastolic flow on duplex scan. Another one of these 9 patients who was 46 years of age had<25 cm s of peak flow velocities in both cavernosal arteries, suggesting that his penile vasculopathy included both defective arterial inflow as well as the presence of CVOD.
Results
The average age of the 23 patients in this case series was 33 years (Table 1), and all complained of ED for >6 months at the time of their clinical presentation. If arterial disease is to be defined as a PSV ≤25 cm s in both cavernosal arteries, only 1 of these 23 patients (4%) met that cutoff and he was 46 years of age. One additional patient, 32 years of age, had one of the two cavernosal arteries with a PSV of 23 cm s whereas the contralateral cavernosal artery registered 33 cm s. If arterial disease, however, is defined as a PSV of ≤35 cm s in both cavernosal vessels, then 3 of the 23 (13%) meet this criterion of arteriolar disease.
Following the intracavernosal injection of a vasoactive substance, only 2 of the 23 patients failed to have a ≥50% dilatation of both of their cavernosal arteries. In one of these patients, there was normal flow in both vessels whereas in the other patient, the PSVs (cm s) were 30 and 27 in each of his cavernosal arteries. There were three other patients who demonstrated a ≤50% dilatation in one of their two cavernosal arteries and in all three of these patients, they had normal bilateral PSVs. All 23 patients, regardless of their PSV, had normal acceleration times.
Fifteen of the 23 patients underwent a DIC. Of these 15 patients, 9 demonstrated the presence of venous leakage although only one of these 9 with a positive DIC test had forward diastolic flow on duplex scan. Another one of these 9 patients who was 46 years of age had<25 cm s of peak flow velocities in both cavernosal arteries, suggesting that his penile vasculopathy included both defective arterial inflow as well as the presence of CVOD.
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