Abstract: PD45-07
Sources of Funding: None

Introduction

PDDU is used as a diagnostic tool in patients with ED to define etiology and prognosticate. However, technical challenges result in difficulty standardizing its performance and interpretation. This study aims to evaluate recent literature on this topic, addressing technical and interpretation limitations.

Methods

A PubMed literature search was performed in August 2016 and included papers published in the English language from 2005 onwards. Review articles were excluded. In our analysis, each study was evaluated for the presence of the following elements pertaining to reporting of PPDU technique and interpretation criteria: (i) agents used (ii) use of a redosing protocol, (iii) reporting of maximum rigidity during study (iv) normative criteria for peak systolic velocity (PSV) and end diastolic velocity (EDV) (v) discrepancy in rigidity between sides (vi) presence of negative EDV values (vii) need for reversal of erection reversal

Results

From a total of 109 published studies, 55 were considered eligible for analysis. 51% reported using PGE1 as the vasoactive injection agent, 20% trimix, 11% papaverine, 7% bimix, 4% used multiple drugs and 7% failed to mention the agent. Only 38% reported using a dosing strategy and 4% reported the percentage of patients requiring multi-dosing. Only 40% mentioned rigidity assessment in their routine, while 55% used a time-based protocol. Discrepancy in between-side rigidity was mentioned in only 4%, while 2% had unilateral cavernosal artery insufficiency reported. Great variability in normative criteria was observed. For normal peak systolic velocity (PSV): 13% used peak systolic velocity (PSV) of ≥35cm/s, 42% ≥30cm/s, 24% ≥25cm/s and 22% failed to report the cut-off used. EDV cut-offs were less heterogeneous: 65% ≤5cm/sec, 4% ≤6cm/sec and 31% failing to report the cut-off. Only 4% reported the presence of negative EDV values. Finally, only 5% mentioned the need for reversal agents after the procedure.

Conclusions

Despite its generalized use, analysis of current literature on PDDU is notable for the lack of standardization in its performance and interpretation. Redosing and rigidity assessment were under-reported, and cut-off values were extremely heterogeneous. There is thus a need for standardization in performing PDDU and reporting results.

Funding

None