Abstract: PD45-08
Sources of Funding: None

Introduction

Penile duplex ultrasound (PDU), combined with pharmacologic stimulation of erection, is the gold standard approach to evaluating multiple penile conditions. The utility of PDU is hindered by a lack of standard approaches to performing and interpreting this study. We examined the variability in international practice patterns, technique and interpretation among practitioners who perform PDU. _x000D_

Methods

A 30-question electronic survey was distributed to members of the International Society for Sexual Medicine (ISSM). The survey assessed current PDU practice patterns, technique and interpretation. Chi-square test was used to determine association between categorical variables. _x000D_

Results

The survey was completed by 9.5% of all 1996 current ISSM members. Of ISSM members surveyed, 80% reported using PDU, with more North American practitioners utilizing PDU than their European counterparts (94% vs. 69%, p < 0.01). Urologists performed 62% of all PDU studies, and more than 76% were interpreted by a urologist. Although 90% of practitioners reported using their own standardized protocol, extreme variation in technique existed among respondents. Over 10 different pharmacologic mixtures were used to generate erections, and 17% of respondents did not repeat dosing for insufficient erection. Urologists personally performing PDU were more likely to report assessing cavernosal artery flow in appropriate fashion with the probe at the proximal penile shaft (73% vs 40%) and at a 60-degree angle (29% vs 5%) compared to urologists who do not perform PDU (p < 0.01). Large differences in PDU diagnostic thresholds were apparent. Only 38% of respondents defined arterial insufficiency with a peak systolic velocity < 25 cm/sec; while 53% of respondents defined venous occlusive disease with an end diastolic velocity > 5 cm/sec. _x000D_

Conclusions

PDU is used by a greater proportion of North American sexual medicine practitioners than European counterparts. Although most respondents report using a standardized PDU protocol, widespread variation exists among practitioners in terms of both technique and interpretation. This variation prevents comparison of PDU results and may impair accurate diagnosis and appropriate treatment of penile conditions. _x000D_

Funding

None