E2908. Imaging for Erectile Dysfunction: Radiologists’ and Urologists’ Perspectives
Authors
Lauren Alexander;
Mayo Clinic - Jacksonville
Bryce Baird;
Mayo Clinic - Jacksonville
Laura Geldmaker;
Mayo Clinic - Jacksonville
Gregory Broderick;
Mayo Clinic - Jacksonville
Joseph Cernigliaro;
Mayo Clinic - Jacksonville
Background
Erectile dysfunction (ED) can result from organic and/or psychogenic etiologies. Imaging plays a role in diagnosing erectile dysfunction, as ultrasound (US) with Doppler is recommended for several indications per European and American Urologic Association guidelines. CT or MR can be used to evaluate patients after surgical management of ED with inflatable penile implants.
Educational Goals / Teaching Points
Understand the pathophysiology of erectile dysfunction, describe a typical US protocol for evaluation, including role of Doppler and intracavernosal injections, recognize US Doppler findings of erectile dysfunction and identify features specific to Peyronie disease, discuss medical and surgical treatment options for erectile dysfunction, determine when to use imaging after penile surgery, recognize normal and abnormal imaging findings of penile implants.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit will review the pathophysiology of erectile dysfunction and Peyronie disease. Case examples are used to illustrate the technique for performing US with Doppler for evaluation of erectile dysfunction and how to interpret the vascular findings. The US, magnetic resonance (MR), and computed tomography (CT) findings of Peyronie disease (PD) are reviewed. Medical and surgical management options are summarized including IPP for ED and PD. To evaluate complications after surgical therapy, CT and MR protocols for evaluation of the symptomatic prosthesis the importance of including deflated and inflated images are discussed. Case examples of complications include shortening due to fibrosis of the tunica albuginea with resultant penile deformity, curvature, and restricted inflation; painful IPP due to malpositioning, improper sizing, buckling, or cylinder cross-over; and other implant malfunction due to leak, aneurysmal expansion, or component detachment.
Conclusion
Understanding the role of imaging for ED before and after surgical management can improve communication between urologists and radiologists on the clinical implications of the imaging findings.
