Digital angiography of erectile failure.

Digital angiography of pudendal and penile arteries was performed in 44 consecutive patients with erectile failure of suspected vascular origin. Intra-arterial injection of contrast medium via selective catheterisation of the hypogastric arteries was used in six cases. In 39 patients, one of whom had already had arterial catheterisation, contrast medium was administered by the intravenous route, using a single, large volume, high speed bolus. In 12/44 cases (27%), digital angiography showed a normal vascular picture at the pudendal and penile level but the remaining 32 patients (73%) had steno-occlusive lesions of different degrees of severity. The pictures obtained after administration of intravenous contrast were diagnostically as good as the studies with selective arterial catheterisation. In addition, the intravenous route allowed the simultaneous representation of the arterial network on both sides and was quicker and less invasive. In 31/44 patients (79%), functional determinations of nocturnal penile tumescence and of penile blood flow with Doppler ultrasonography were performed for comparison. Nocturnal penile tumescence results correlated well with the angiographic picture. Penile blood flow measurements with the Doppler technique were less sensitive than digital angiography.