Rigi10™ Malleable Penile Prosthesis
Also Known As
Penile Duplex Doppler Ultrasound, Penile Color Doppler Ultrasonography, CDUS penis, Penile Doppler Sonography, Penile Arterial Blood Flow Study, Penile Blood Flow Assessment, Doppler Ultrasound of the Penis¹
Definition
Penile Doppler ultrasonography, also known as Penile Duplex Doppler Ultrasound or Color Doppler Ultrasonography (CDUS) of the penis, is a specialized, noninvasive or minimally-invasive diagnostic imaging test that utilizes high-frequency sound waves to visualize the anatomical structures of the penis and evaluate blood flow within its vessels in real time.¹ It is a crucial tool for assessing penile hemodynamics, particularly in the context of erectile dysfunction (ED). The procedure involves using an ultrasound probe placed on the penis, typically after the administration of a vasoactive agent (like prostaglandin E1, papaverine, or phentolamine) to induce an erection, allowing for the measurement of blood flow parameters such as peak systolic velocity (PSV) and end-diastolic velocity (EDV) in the cavernosal arteries.¹ This helps in identifying abnormalities in arterial inflow or venous outflow (veno-occlusive dysfunction) that can contribute to ED.¹ Its purpose is to depict normal anatomy, identify macroscopic pathologic changes, and analyze functional changes in penile blood flow, thereby aiding in the diagnosis and classification of ED, priapism, and Peyronie’s disease.¹
Clinical Context
Penile Doppler ultrasonography is clinically indicated for the evaluation of erectile dysfunction (ED), particularly in patients who do not respond to oral phosphodiesterase type 5 inhibitors (PDE5-I).¹ It helps differentiate between various causes of ED, such as arteriogenic (impaired arterial inflow), veno-occlusive dysfunction (venous leak), or mixed types.¹ The procedure is also valuable in assessing postoperative ED in cancer survivors, for example, after pelvic surgery for prostate, bladder, or rectal cancer.¹ Additionally, penile CDUS can play a role in the detection of silent coronary artery disease (CAD) in men presenting with ED, as ED is recognized as an early manifestation of endothelial dysfunction and peripheral vascular disease.¹ It is also used in the evaluation of priapism (to differentiate between ischemic and non-ischemic types) and Peyronie’s disease (to assess plaque characteristics and associated vascular changes).¹ Patient selection criteria typically involve men experiencing persistent ED. The procedure involves inducing an erection with intracavernosal injection of vasoactive drugs, followed by ultrasound scanning to measure blood flow parameters like Peak Systolic Velocity (PSV) and End-Diastolic Velocity (EDV).¹ Expected outcomes include a definitive diagnosis of the vascular component of ED, which guides further management strategies. For example, a PSV < 25 cm/sec is indicative of arterial insufficiency, while a persistent EDV > 5 cm/sec suggests veno-occlusive dysfunction.¹