Diagnostic value of audiovisual sexual stimulation combined with pharmacopenile doppler ultrasonography in the patients with severe ED
Objective To investigate the significance of audiovisual sexual stimulation(AVSS)combined with Pharmacopenile Doppler ultrasonography(PDDU)in the diagnosis of patients with severe erectile dysfunction(ED)using a pre-and post-control mode.Methods From June 2015 to July 2016,the patients with chief complaints of ED were screened in Urological Department of the Third Xiangya Hospital,Central South University.International Erectile Function Rating Scale 5(IIEF-5)was used for preliminary screening.A total of 139 patients with severe ED whose IIEF-5 score was less than 8 were enrolled in the study.Using self-control study,two sessions of PDDUs were examined on patients.The first session examination was conducted only using intracavernous injection(ICI)of prostaglandin E1(group A),and 7 days later,the second session examination was done using audiovisual sexual stimulation(AVSS)combined with ICI of prostaglandin E1(group B).Penile vascular parameters,including the peak systolic velocity(PSV),the end diastolic velocity(EDV)and the resistive index,at the 5,10 and 20 minutes after the injection were recorded.Results In Group A,117 patients were detected as vascular ED,including 54 arteriogenic ED,40 veno-occlusive ED,and 23 mixed vasculogenic ED.In Group B,a total of 91 patients were detected as vascular ED,including 34 arterial ED,30 venous ED,and 27 mixed vasculogenic ED.The injection doses and times of vasoactive drug in group B were significantly lower than those in group A,and it was found that AVSS combined with ICI of prostaglandin E1 could improve the detection rate of non-vascular ED,and 26 patients were considered as false positives.Conclusions Combination of AVSS with ICI of prostaglandin E1 can improve the detection rate of non-vascular ED by PDDU.Combination of AVSS with ICI of prostaglandin E1 can effectively reduce the dose of vasoactive drug and the times of injections required for penile erection.
erectile dysfunctionultrasonography,doppleraudiovisual sexual stimulationpenile erection
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