doppler

im 40 years old male who for the last 2 years has had alot of pressure and axiety from work and life events. Recently I went to the urologist for intermitent ED. I wake 2 times a week with an erection. I have also done the test at night for night time erections. The test showed I have night time erections. I figured it was stress. The urologist did a doppler with injection. He did the test in the office. He has done a fellowship in ED. I also am familar with doppler exams because of my field. The doctor said that I had venous leakage but i over come it and that the PSV was 30 which was low for my age. Since I smoked he felt that the the problems I was having consistently obtaining a erection was organic along with the axiety. I wasnt clear weather there was really a problem here or not. As I started to read on the subject I found that a PSV of 30 wasnt bad. I took a ultrasound machine and got a PSV of 36 with no injection. The time from the begining of systole and PS was good also. In both exams. I was able to obtain a full erection with the injection ( although he gave me a second injection.) I guess what I am asking here is ....is there another test that I can take that will define the problem here. MRA? The urologist was kinda vague on the whole thing. He said you have leakage but over came it,  and although your PSV wasnt bad its not as good as expected for your age . So I feel that there is a mild arterial problem. Talking to two friends that are vascular surgeons they said that mild problems dont cause symptoms. I dont know.  Any light on this would help. Should I have the test repeated somewhere else. Another test?

[Kevin Pho, MD]

Hello - thanks for asking your question.

One comprehensive test would be nocturnal penile tumescence testing.  This test quantify the number, tumescence and rigidity of erectile episodes a man experiences as he sleeps.  It can identify men with underlying arterial or venous disorders who might benefit from corrective vascular surgery.

MRA is in the investigational stage.  Angiography would be the definitive test in determining any venous leakage that would be amenable to surgery.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[Ffargo101]

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