Penile Doppler Ultrasound is a procedure that is used to predict the response of your erectile dysfunction (ED) to vasodilation medications that enhance blood flow to the penis. It also allows the urologist to determine and document if you have an inflow or outflow type of erectile dysfunction. Erectile dysfunction has many causes. [Some respond well to the vasodilator drugs initially or for the rest of your life.] Some diseases such as arteriosclerosis, a.k.a. plaque in the blood vessels (associated with heart disease), high blood pressure, and diabetes exert their damaging effects on blood vessels throughout the body, the penis included.
If your disease causes an inflow type of erectile dysfunction, over time or when you present to our office for the first evaluation, the vasodilator drugs may not be able to dilate the arteries feeding the erectile bodies. It would be wasteful and inconvenient to you to try all these therapies if this study could predict their failure up front.
If you have a severe type of outflow erectile dysfunction, then any therapy that causes an increased inflow during erection may not be adequate for maintaining erections hard enough and/or long enough for satisfactory intercourse. Depending on the severity these outflow problems may only be adequate treated with a surgically place penile prosthesis.
The test will be performed while you are lying on your back on the examining room table. A penile injection of a vasodilator agent called Trimix will be performed using a very small needle. This will help to relax the erectile muscles in your penis, dilate your penile arteries. This will result in an increase in the blood flow to your penis and give you an erection. Most people experience just a tiny “insect bite” sensation with the injection.
Using a small ultrasound probe, placed along the shaft of the penis, we will measure the blood flow in the penile artery on both sides of the penis.
There is no pain involved during this portion of the procedure.
You might experience mild discomfort during the penile injection. About 10% of patients may experience an ache from the actual injection medication. You might also develop a small bruise in the skin at the site of the injection.
The erection should go down within 4 hours; however, occasionally some patients may experience a very prolonged erection, lasting more than 4 hours. If this happens, a small needle is used to inject a reversal medication. Please contact the office immediately (954-463-6408) during open hours, and after hours go to the emergency department to treat the prolonged erection.