Doppler

Subject: doppler
Topic Area: Urology - General
Forum: The Urology Forum

Present question is given here in the form of a letter. The answer is following.

I am 40 years old male, having a lot of work and life anxiety and pressure during the last two years. Recently I went to the urologist for intermittent ED (erectile dysfunction). The problem is that I wake up with erection twice a week. I have also done night test for night time erections. It was positive and confirmed that I have night erections. I thought it could be because of the stress. The urologist did a Doppler with injection and the test was made in the office. Because of my job I am a bit familiar with Doppler exams. The doctor said that I had venous leakage but I overcome it and that the PSV was 30 which was low for my age. The doctor supposed that the problem with erectile dysfunction was connected with anxiety and smoking. But it was not quite clear. As I started to read on the subject I found that a PSV of 30 was not bad. I took an ultrasound machine and got a PSV of 36 with no injection. The time from the beginning 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 kind of vague on the whole thing. He said you have leakage but overcame it, and although your PSV was not bad it is not as good as expected for your age. So I feel that there is a mild arterial problem. I have talked to two vascular surgeons and they said that there can be no symptoms if the problem is not big enough. But I do not know what to think and any help will be appropriate. Do I need to have another test made somewhere else? Or to repeat this test in another place?

The answer is:
One comprehensive test would be nocturnal penile tumescence testing. This test quantifies 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.

Although there is an answer for the asked question here, it does not mean that it substitutes seeing the doctor. It just helps to understand the problem more and decide what doctor to visit. And it is advisable to consult a personal doctor for treating your very case.