Penile non imaging and imaging Flashcards
Helps determine whether impotence is related to peripheral vascular insufficiency
Capabilities of Penile non imaging and imaging
Sensitivity to injectable medication; and/ or anticoagulation therapy may prevent use of the injection component
Limitations
What position is the patient in to perform this exam?
Supine
Doppler previosuly described (CW)
Plethysmographic tenchinques
Duplex scanning principles
Physical principles
Doppler velocity signals obtained bilat (CFA, PTA, PDA)
Appropriate BP cuffs placed on upper arms and ankles
Calculate ABI
Techniques for non imgaing
Poor arterial inflow to LE due to proximal obstruction may affect
Penile arterial inflow
What is obtained with Doppler of PPG as the “end point detector”
Penile pressures (Techniques)
Where do you place the probe
Lateral or ventral
What size cuff do you use
2.5 x 12.5 cm
Penile plethysmographic wave forms obtained
Techniques
Penile/Brachial index
Normal =
Marginal =
Abnormal =
> .75
.65 - .74
< .65
Reduced presssure highly suggestive of
More proximal arterial disease (aorta-iliacs, internal iliacs)
Abnormal plethysmographic tracings show
marked reduction in amplitude
What probe is used?
7 - 10 MHz (linear array transducer)
Prior to medication injection what is measured:
Cavernous artery transverse AP measurement
PSV/ED obtained
Where is the specific medication injected into the penis ?
Lateral aspect, Proximal shaft of the penis to induce erection
When are measurements taken after the injection?
1 - 2 minutes post injection
What vein is measures?
Dorsal veins flow velocity is measured?
How long should the erection last up to?
3 hours no more than 3 hours
Diameter of cavernous artery should increase post injection
Doppler flow is higher resistant pre injection; lower resistant post injection
Normal
PSV measurements should increase
Normal
What is normal range for PSV
30 cm/sec or higher
(anything less is abnormal)
Dorsal vein velocities should not increase
Normal
If there is in increase the dorsal vein could suggest
venous leak
Normal measurements of dorsal vein is
< 3 cm/sec
Abnormal measurements of dorsal vein is
> 20 cm/sec