Chapter 7: Penile Imaging Flashcards
Purpose of Penile Doppler
to help determine whether impotence is related to a peripheral vascular insufficiency
Limitations of Penile imaging
anxiety
duplex needed for velocities and anatomic conditions
sensitivity to injections/injectable medications
Penile Doppler Patient positioning
supine with appropriate draping to maintain privacy
Physical principles for penile imaging
doppler
plethysmographic techniques
duplex
Penile imaging technique
doppler obtained bilat at CFA, PTA, DPA
BP cuffs on brachials and ankles
Calculate ABI
Penile pressures obtained with doppler or PPG
probe placement: lateral of ventral
penile plethysmographic waveforms obtained as needed
penile imaging cuff size
2.5cm x 12.5cm
poor arterial inflow to LE due to proximal obstruction may
affect penile arterial flow
penile brachial index normal
> or = to .75
penile brachial index marginal
> or = to .65-.74
penile brachial index abnormal
< .65
vasculogenic impotence
reduced penile pressure is highly suggestive of
proximal arterial disease (ex: aorto-illiac: internal illiac arteries)
penile imaging exam steps
7-10MHz transducer
obtain consent
prior to injection the cavernous arteries measured A/P diameter in trv; PSV and EDV obtained
inject meds into lateral aspect, prx shaft to induce erection
measure cavernous arteries 1-2 post injection
dorsal vein flow velocity is measured
if erection is maintained for ____ hours patient must contact urologist
3 hours
Penile doppler normal results
diameter of cavernous arteries should increase post injection
PSV should increase approx 30cm/sec higher
dorsal vein velocities should not increase
penile imaging: dorsal vein increase
could suggest venous leak
normal: < 3cm/sec
abnormal >20 cm /sec
