Objective To evaluate the value of intracavernosal injection of the vasoactive agent (prostaglandin E) combined with color duplex doppler ultrasound (CDDU) examination for the diagnosis of vasculogenic erectile dysfunction (ED). Methods 50 patients were induced to erection by intracavernosal injection of prostaglandin E before the examination. After full erection, the maximum penis systolic velocity (PSV), end diastolic velocity (EDV) and resistant index ［RI= (PSV-EDV)/PSV］ of corpus cavernosum penis arteries were recorded by color duplex doppler ultrasonic diagnostic system. And the diagnostic value of CDDU for vascular ED was assessed. Results There were 24 cases diagnosed as nonvasculogenic ED, 14 cases as arteriogenic ED and 12 cases as venogenic ED. In the nonvasculogenic ED group, PSV was more than 25 cm/s, EDV=0 or was close to 0, RI＞0.9. In the arteriogenic ED group, PSV was lower than 25cm/s. In the venogenic ED group, PSA was increased, EDV＞5 cm/s, RI was lower than 0.85, and the cavernorography revealed penile venous leakage in 2 cases. There was no difference in flaccid penis systolic weak velocity (FPSV) among three groups (P＞0.05). When erection was performed, PSV and EDV were significantly higher in nonvasculogenic ED group compared to the arteriogenic ED group and the venogenic ED group (P＜0.05). Conclusions The CDDU examination is conducted after patients are induced to rection by intracavernosal injection of the vasoactive agent (prostaglandin E). This approach can exclude the inherent variable factors due to penis weakness, quantitatively reflex hemodynamic state of penis, and provide a reliable basis for vasculogenic ED screening, especially for arteriogenic ED. And it is superior to arterial angiography and has value of clinical application.

• ref