Karadeniz T, Ariman A, Topsakal M, Eksioglu A, Engin T, Basak D
Department of 2nd Urology, SSK Okmeydani Hospital, Istanbul, Turkey.
Urol Int. 1995;55(3):143-6. doi: 10.1159/000282772.
The gold standard in the diagnosis of venous impotence is cavernosometry. But a less invasive and time-consuming screening test for patients with a high probability of venous impotence is required. Therefore we evaluated 82 men with erectile dysfunction by color Doppler sonography after intracavernosal injection of 60 mg papaverine. 28 of them who had a poor erectile response but sufficient arterial inflow were included in this study. 6 patients who were previously found to have psychogenic impotence formed the control group. After pharmacological stimulation by papaverine, all patients were examined for 20 min by color Doppler sonography in order to detect diastolic flow velocities in the cavernosal arteries and erectile responses. Both groups of patients underwent pharmaco-cavernosometry in a blind fashion afterwards. The diagnosis of venous impotence with color Doppler sonography was confirmed by dynamic pharmaco-cavernosometry in 25 of 28 (89%) and 6 of 6 (100%) subjects of the study and control groups, respectively. Statistically, in the diagnosis of venous dysfunction, color Doppler sonography had a sensitivity of 100%, specificity of 66.6%, accuracy rate of 91% and a positive predictive value of 0.892. The gold standard in the diagnosis of venous impotence is still cavernosometry, but it seems that color Doppler sonography may provide a sensitive assessment of penile venous competence.
静脉性阳萎诊断的金标准是海绵体测压法。但对于静脉性阳萎可能性高的患者，需要一种侵入性较小且耗时较短的筛查试验。因此，我们对82例勃起功能障碍男性患者在海绵体内注射60mg罂粟碱后进行了彩色多普勒超声检查。其中28例勃起反应差但动脉血流充足的患者被纳入本研究。6例先前被诊断为精神性阳萎的患者组成对照组。在罂粟碱进行药物刺激后，所有患者均接受20分钟的彩色多普勒超声检查，以检测海绵体动脉的舒张期血流速度和勃起反应。之后两组患者均以盲法进行药物海绵体测压。在研究组和对照组中，分别有25/28（89%）和6/6（100%）的受试者通过动态药物海绵体测压法证实了彩色多普勒超声对静脉性阳萎的诊断。从统计学角度来看，在静脉功能障碍的诊断中，彩色多普勒超声的敏感性为100%，特异性为66.6%，准确率为91%，阳性预测值为0.892。静脉性阳萎诊断的金标准仍然是海绵体测压法，但彩色多普勒超声似乎可以对阴茎静脉功能进行敏感评估。
