Color Doppler ultrasound results of erectile dysfunction patients after an intracavernosal injection of prostaglandin E1: an analysis of 9,109 cases

Background: Previous studies on penile color Doppler ultrasound (CDU) examination after intracavernosal injection (ICI) have included a small number of patients and rarely focused on the effects of intracavernous communicating branches and persistent rigid erection. This study aimed to explore these issues using a large institutional database of erectile dysfunction (ED) patients. Methods: We conducted a retrospective study of 9,109 ED patients who underwent CDU examination after ICI with prostaglandin E1 (PGE1) at our Department of Andrology. Results: Obvious communicating branches between the bilateral cavernous arteries were observed in 200 patients, and the blood flow of the main trunk of the cavernous artery was significantly better than that of the main branch. Another 19 patients remained in a phase of persistent rigid erection and showed no obvious blood flow in at least one cavernous artery. Based on the peak systolic velocity (PSV) and end diastolic velocity (EDV), the remaining 8,890 patients were allocated to non-vascular, arterial, and venous ED groups. Based on the erection duration, the patients in the non-vascular ED group were allocated to persistent erection and non-persistent erection subgroups. The data of each group were standardized and statistically analyzed according to the age gradient. The PSV of the persistent erection, arterial ED, and venous ED groups showed a negative correlation with age, while the EDV of the arterial ED and venous ED groups showed a positive correlation with age. Conclusions: The CDU parameters were found to be correlated with age. Additionally, the communicating branches between bilateral cavernous arteries and persistent rigid erection significantly affected the CDU results.