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• W2086770003 abstract "You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Evaluation I1 Apr 2015MP43-07 VASCULAR RISK FACTORS DO NOT PREDICT PENILE DOPPLER DUPLEX ULTRASOUND RESULTS IN OLDER MEN Kelly A. Chiles, Christian J. Nelson, and John P. Mulhall Kelly A. ChilesKelly A. Chiles More articles by this author , Christian J. NelsonChristian J. Nelson More articles by this author , and John P. MulhallJohn P. Mulhall More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1614AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Erectile dysfunction (ED) may be organic resulting from changes in erectile hemodynamics, or non-organic related to elevated sympathetic tone. A common presumption is that older men with ED have organic ED. Color Duplex Doppler Ultrasound (CDU) is the gold standard for defining erectile hemodynamics (HDX). We aimed to determine if older men with vascular disease risk factors (VDRF) routinely had a vascular etiology to their ED. METHODS All men ≥67 years who underwent CDU for ED were included. Men with unilateral cavernosal artery insufficiency (CAI), unilateral venous leak (VL), or men with bilateral VL who required post-CDU erection reversal were excluded. CDU was done using repeat injection dosing to maximal rigidity. CAI was defined as bilateral peak systolic velocity ≤25 cm/s, and VL as end diastolic velocity ≥ 5 cm/s. On history, loss of sustaining (LOS) of erection was defined as being a risk factor for non-vasculogenic psychogenic ED (NVED). We tested the following for an association with NVED and VL: age, BMI, Peyronie's disease (PD), hypogonadism, number of VRFs, LOS, radical prostatectomy (RP), radiation treatment (RT), and androgen deprivation therapy (ADT). RESULTS The mean age of the 130 men included was 72±3 (range 67-81) years. Mean BMI = 28±4. Median VDRF number = 2 (IQR=1). VRF included: hypertension (50%), dyslipidemia (54%), cigarette smoking (47%), coronary artery disease (10%), diabetes (9%). 2% had CAI, 43% had VL, and 55% had normal HDX. 36% had an RP, 11% had RT, and 6% had ADT. Age (r=0.24, p=0.01) and the absence of PD (r=-0.23, p=0.01) were the only two univariate associations with the presence of VL. On multivariable analysis, including all the variables tested in the univariate analyses, age (OR=1.19, CI:1.04-1.35, p=0.01) and the absence of PD (OR=0.41, CI:0.18-0.96, p=0.04) were the only significant predictors of VL. In the univariate analyses, age (r=-0.24, p=0.01) and presence of PD (r=0.24, p=0.01) were the only two univariate associations with the normal hdx. LOS was marginally related to a normal HDX (r=-0.14, p=0.14). On multivariable analysis, including all the variables tested in the univariate analyses, age (OR=0.84, CI:0.74-0.96, p=0.01), PD (OR=2.40, CI:1.04-5.63, p=0.04), and LOS (OR=0.24, CI:0.56-1.00, p=0.05) were predictors of normal HDX. CONCLUSIONS The presence of multiple VDRF does not predict vasculogenic ED. Over half of the men older than 67 years had normal erectile HDX and were diagnosed with NVED. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e520 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kelly A. Chiles More articles by this author Christian J. Nelson More articles by this author John P. Mulhall More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2086770003 title "MP43-07 VASCULAR RISK FACTORS DO NOT PREDICT PENILE DOPPLER DUPLEX ULTRASOUND RESULTS IN OLDER MEN" @default.
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