Penile Doppler Ultrasound

What is a Penile Doppler?

A Penile Doppler Ultrasound is a diagnostic imaging test used to evaluate blood flow in the penile arteries and veins. It is commonly performed to assess erectile dysfunction (ED), vascular abnormalities, or penile trauma.

Indications:

• Erectile Dysfunction (to differentiate between vascular and psychological causes).

• Penile Arterial Insufficiency.

• Venous Leak (excessive blood drainage causing ED).

• Peyronie’s Disease (penile curvature due to scar tissue).

• Trauma or Injury to the Penis.

• Pre- and Post-Surgical Evaluation for Penile Implants.

Procedure:

1. Preparation:

   • The patient is asked to refrain from taking any erectile dysfunction medication before the test.

   • The procedure is done in a private setting.

2. Baseline Ultrasound (Flaccid State):

   • A high-frequency ultrasound probe is placed on the penis to assess the anatomy and blood flow in the flaccid state.

3. Erection Induction (If Needed):

   • An intracavernosal injection (vasodilator like Alprostadil) is administered to induce an erection.

   • This helps evaluate the penile arteries and venous function under stimulated conditions.

4. Doppler Imaging (Erect State):

   • The ultrasound measures Peak Systolic Velocity (PSV) and End Diastolic Velocity (EDV) to assess arterial inflow and venous leakage.

5. Post-Test Monitoring:

   • If the erection lasts longer than 2–3 hours (priapism risk), reversal medication (phenylephrine) may be given.

Results & Interpretation:

• Normal Arterial Flow: PSV > 30 cm/s (Good blood supply).

• Arterial Insufficiency: PSV < 25 cm/s (Poor arterial blood flow).

• Venous Leak: EDV > 5 cm/s (Excessive blood drainage causing erection loss).

• Peyronie’s Disease: Presence of plaques or fibrosis affecting blood flow.

Advantages of Penile Doppler:

✔ Non-invasive and painless (except for the injection).
✔ Provides accurate assessment of vascular causes of ED.
✔ Helps determine if medications, PRP therapy, or surgery is needed.