Penile Non-imaging and Imaging Flashcards

1
Q

What are the capabilities of penile non-imaging and imaging?

A

Determine whether impotence is related to peripheral vascular insufficiency

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2
Q

Limitations of penile non-imaging and imaging:

A
  • High level of anxiety or antagonism
  • Duplex needed for velocities and anatomic conditions
  • Sensitivity to injectable medication; and/ or anticoagulation therapy may prevent use of the injection component
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3
Q

What is patient positioning for penile imaging?

A

supine

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4
Q

Physical principles for penile imaging:

A
  • Doppler previously described
  • Plethysmographic techniques
  • Duplex scanning principles
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5
Q

Technique for penile non-imaging:

A
  • Doppler velocity signals obtained bilateral (CFA, PTA, DPA)
  • Appropriate cuffs placed on upper arms and ankles
  • Penile pressures obtained with doppler or PPG as the “end point detector” probe placement: lateral and ventral.
  • Penile plethysmographic waveforms obtained
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6
Q

What cuff is used for penile non-imaging?

A

205cm x 12.5 cm

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7
Q

What obstruction could possibly affect penile arterial flow?

A

Poor arterial inflow due to LE proximal onstruction

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8
Q

Penile / Brachial Index:

Normal -
Marginal -
Abnormal -

A

Normal = > 0.75
Marginal = 0.65 - 0.74
Abnormal = < 0.65

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9
Q

Reduced penile pressure is highly suggestive of:

A

more proximal arterial disease (aortic-iliac: internal iliacs)

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10
Q

What doe abnormal plethysmographic tracings show?

A

marked reduction in amplitude

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11
Q

What transducer do you use for penile imaging?

A

7 to 10 MHz transducer

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12
Q

Prior to injection of medication, which arteries are measured?

A

cavernous arteries (AP) in transverse

PSV, EDV obtained

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13
Q

Where is the medication injected?

A

lateral aspect, proximal shaft of penis

(to induce erection)

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14
Q

When are the cavernous arteries re-measured?

A

1-2 minutes post-injection

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15
Q

What is the last step of penile imagin?

A

Dorsal vein flow velocity is measured

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16
Q

How long can an erection last post medication before the patient needs to contact urology to reverse priaprism?

A

3 hours

17
Q

What are the normal outcomes of penile imaging?

A
  • Diameter of cavernous arteries should increase post-injection
  • PSV measurements should increase
  • Dorsal vein velocities should not increase
18
Q

What is a normal range of PSV?

A

30 cm/sec or higher

  • anything less is abnormal
19
Q

What does an increase in the dorsal vein suggest?

A

venous leak

20
Q

What is a normal and abnormal measurement in the dorsal vein?

A

Normal - < 3 cm/sec

Abnormal - >20cm/sec