Rigi10™ Malleable Penile Prosthesis
Also Known As
Penile Duplex Doppler Ultrasound, PDDU, Penile Color Doppler Ultrasonography, Penile CDUS, Dynamic Duplex Ultrasound of the Penis (DDUP), Penile Vascular Study, Color Duplex Penile Ultrasound
Definition
Penile Doppler Ultrasound is a high-performing, minimally-invasive diagnostic imaging procedure that measures blood flow in the penis after the injection of vasodilator medications.1 This specialized ultrasonography technique allows for real-time visualization of penile vascular anatomy and hemodynamics, enabling clinicians to differentiate between vascular and non-vascular causes of erectile dysfunction (ED).2 The procedure involves ultrasound imaging of the penis in both flaccid and erect states (following vasodilator injection), measuring critical parameters such as peak systolic velocity (PSV), end diastolic velocity (EDV), and cavernosal artery diameter to evaluate arterial insufficiency or venous leak.3 This diagnostic test is essential for determining whether a patient has an inflow or outflow type of erectile dysfunction, which guides appropriate treatment selection.4
Clinical Context
Penile Doppler Ultrasound is primarily used in the clinical evaluation of erectile dysfunction, particularly when first-line oral medications (such as PDE5 inhibitors) fail to produce adequate results.1 The procedure is especially valuable for patients with suspected vascular causes of ED, including those with risk factors such as diabetes, hypertension, hyperlipidemia, and cardiovascular disease.2
Patient selection criteria typically include men with:
Non-response to oral ED medications3
Young patients with sudden onset ED4
Post-surgical ED (especially after pelvic surgery for prostate, bladder, or rectal cancer)1
Suspected Peyronie’s disease with associated ED2
History of pelvic or perineal trauma3
Evaluation of penile masses or abnormalities4
The procedure involves the patient lying supine while a high-frequency linear ultrasound probe examines the penis in both longitudinal and transverse views.1 After baseline measurements in the flaccid state, a vasoactive medication (typically prostaglandin E1, papaverine, or Trimix) is injected into the lateral aspect of the penile shaft to induce an erection.2 The ultrasound is then repeated to measure changes in blood flow parameters.3
Expected outcomes include classification of ED as arterial insufficiency, venous leak (veno-occlusive dysfunction), or mixed vascular etiology, which guides subsequent treatment decisions.4 The procedure has a high diagnostic accuracy when performed correctly, though factors such as patient anxiety, inadequate sexual stimulation, or improper medication dosing can affect results.2
Potential complications include prolonged erection (priapism), pain, hypotension, and hematoma at the injection site, which patients should be informed about before the procedure.1