Objective
To define the role of cavernosal venous occlusive dysfunction (CVOD) as the only cause
of erectile dysfunction (ED).
Materials and Methods
Patients meeting the CVOD criteria without any risk factors for organic ED were randomized
into 2 groups; the end-diastolic velocity (EDV), peak systolic velocity (PSV), and
resistive index (RI) of their cavernosal arteries were assessed using color duplex
Doppler ultrasound (CDDU) after intracavernous injection (ICI) of 10 µg alprostadil.
Group 1 (153 patients) underwent repeated CDDU + ICI assessments (a maximum of 3 rounds).
Group 2 (149 patients) underwent CDDU + ICI before and after sexological counseling.
The percentage data were analyzed using the Cochran-Mantel-Haenszel test; the numerical
data were analyzed using the Wilcoxon test.
Results
For group 1, the PSVs (median values: first round 42 cm/s; second round 54 cm/s; third
round 66 cm/s) and RIs (median values: first round 70%; second round 89%; third round
92%) increased significantly in each CDDU + ICI round, whereas the EDVs were significantly
lower (median values: first round 11 cm/s; second round 5 cm/s; third round 1 cm/s).
For group 2, the PSVs (median values: from 44 to 67 cm/s) and RIs (from 72% to 93%)
increased significantly after sexological counseling, whereas the EDVs (median values:
from 12 to 1 cm/s) were significantly lower.
Conclusion
Repeated CDDU + ICI and counseling strongly diminished the percentage of patients
meeting the CVOD criteria, leading to the suspicion that CVOD is linked to psychological
issues in highly selected young healthy men with ED.
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Article info
Publication history
Published online: November 16, 2017
Accepted:
November 2,
2017
Received:
June 22,
2017
Footnotes
Financial Disclosure: This research received no financial support from any funding agency or industry, and no potential financial conflicts of interest exist for either author. There is no meaningful affiliation or involvement, either direct or indirect, with any organization or entity having a direct financial interest in the subject matter or materials discussed (eg, employment, consultancies, grants, honoraria).
The authors state that this paper has been submitted solely to Urology, has never before been published, nor has it been submitted simultaneously elsewhere.
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© 2017 Elsevier Inc. All rights reserved.
