How does it work
The penile echocolordoppler is an imaging technique widely used in the diagnosis of erectile dysfunction, thanks to its ability to analyze the penile blood flow and to highlight its main alterations.
The penile echocolordoppler uses high-frequency ultrasound probes (7.5-13 MHz) equipped with digital software and a color-Doppler module, which allow analyzing the waves reflected by the corpuscular part of the blood flowing in the penile vessels. During the examination the sound waves are exploited, without administering any kind of dangerous radiation.
Dynamic echocolordoppler
In addition to ultrasound probes and related instrumentation, the penile echocolordoppler, dressed in the adjective "dynamic", calls for the use of vasoactive drugs, such as papaverine and / or prostaglandin PGE1 (Alprostadil - Caverject) - injected directly into the corpus cavernosum of the penis to induce a pharmacological erection.
In this way, by performing the penile echocolordoppler in basal conditions and repeating it at pre-established intervals after the injection of the drugs (fic-test), it is possible to study the size and state of dilation of the cavernous arteries, the rate of blood flow to the 'inside of the vessels of the penis, and the structure of the corpora cavernosa at rest and in erection. The exam is also able to study the morphology of the penis, highlighting any ecostructural alterations such as fibrosis or calcified plaques.
In addition to the injection of drugs that cause penile vasodilation, during the examination some doctors make an erotic video available to the patient; this approach is dictated by the attempt to minimize the emotional component, with blocks of a psychic nature that could alter the results of the examination. Although - unlike the classic PDE5 inhibitors tadalafil, vardenafil, sildenafil, avanafil - the drugs injected into the corpora cavernosa do not need a psychic excitement to induce an erection, the patient's anxiety could still lead to a reduced response to the drug.
When you run
The penile echocolordoppler is generally the first line examination in case of clinical suspicion of erectile dysfunction on a vascular basis, for example in patients suffering from atherosclerosis, diabetes, hypertension or with other cardiovascular risk factors. The doctor can also prescribe the test after having tested the therapeutic ineffectiveness of oral therapies for erectile dysfunction.
In case of positive results, to identify the presence and the exact location of an arterial problem or a venous leak highlighted by the penile echocolordoppler, it is necessary to resort to more invasive diagnostic investigations, such as cavernosometry, dynamic cavernography and the selective dynamic arteriography of the penile arteries.
How it happens
During the penile echocolordoppler the patient is normally studied in the supine position (lying on his stomach) with the penis resting on the anterior wall of the abdomen. The examination - which takes about 30 minutes - is not painful and intracanvernose injection of the drugs, if carried out according to the correct technique, well known to the doctor, besides being almost painless, does not cause any harm to the patient.
risks
The only possible complication of the penile echocolordoppler lies in the appearance of priapism : an erection that lasts beyond the time of effectiveness of the drug (about 1 hour) and that can become painful. If it occurs, priapism can easily be treated by appropriate local pharmacological therapies, such as intracavernous administration of ethylphrine, and only in rare cases requires surgical detumescence.
