Vascular Assessment of Erectile Dysfunction

The discovery that penile erection is a vascular phenomenon the quality of which is adversely affected by identifiable clinical factors coincided with the advent of multiple technologies for penile imaging. The 1980s and 1990s saw the development of many penile diagnostics; of these technologies, color duplex Doppler ultrasound is the least invasive and most informative. Before the wide availability of Doppler technology, a vasoactive penile injection administered in the office permitted the physician to roughly distinguish between severe arterial disease and psychogenic erectile dysfunction (ED). Whether the agent is papaverine, prostaglandin E1, or a combination of vasoactive medications, the addition of duplex Doppler ultrasound provides greater objective criteria for evaluating penile responses.