Cavernous Artery Intima-Media Thickness: A New Parameter in the Diagnosis of Vascular Erectile Dysfunction |
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| Authors: | Nicola Caretta Pierfrancesco Palego Mirko Schipilliti Alberto Ferlin Antonella Di Mambro Carlo Foresta |
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| Affiliation: | 1. Department of Histology, Microbiology and Medical Biotechnologies, Section of Clinical Pathology, Centre for Male Gamete Cryopreservation, University of Padova, Padova, Italy;2. Department of Cardiovascular Surgery, University of Padova, Padova, Italy;3. Department of Cardiac, Thoracic and Vascular Sciences, Division of Cardiology University of Padova, Padova, Italy;4. National Council Research, Institute of Neuroscience, Padova, Italy;1. The Department of Anesthesiology, The University of Arizona College of Medicine, Tucson, AZ, USA;2. The Department of Physiology, Faculty of Health Sciences, University of Pretoria, Arcadia, South Africa;1. Department of Clinical Medicine, Clinical Immunology Unit–Scleroderma Center, Sapienza University of Rome, Rome, Italy;2. Department of Clinical Medicine‐Nephrology Unit ,Sapienza University of Rome, Rome, Italy;3. Department of Experimental Medicine, Section of Medical Physiopathology, Food and Science and Endocrinology Section, Sapienza University of Rome, Rome, Italy;4. U.O.C. Medicina Clinica e Reumatologia, Università Campus Bio‐Medico, Rome, Italy |
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| Abstract: | IntroductionA precise characterization of erectile dysfunction (ED) of vascular origin has not yet been achieved. Although cavernous peak systolic velocity (PSV) is generally considered a major parameter, it has many false positives and negatives because of anatomic variations of the cavernous artery course, challenging site of sampling, insufficient caracterization of an early phase of vascular disease, and significant influence of adrenergic tone.AimWe performed a high magnification ultrasonographic study in order to compare functional and morphological parameters of the cavernous artery to PSV and their relation with penile and systemic atherosclerosis.MethodsA total of 109 subjects (84 ED patients and 25 controls) evaluated in our andrological center from March 2007 to January 2008 were enrolled in the study.Main Outcome MeasuresAll subjects underwent medical history, erectile function domain of the International Index of Erectile Function, physical examination, routine and sex hormone blood tests, and high resolution echo color doppler evaluation of carotid, femoral and penile districts (acceleration time, intima media thickness [IMT], intima adventitia thickness, caliper before and after intracavernous alprostadil injection [Δ-cavernous calliper]).ResultsCavernous parameters were significantly different between ED and controls. Multivariate model showed that IMT was the only predicting parameter for ED of vascular origin. Cavernous IMT showed a strong direct correlation with carotid and femoral IMT. ED patients with two or more cardiovascular risk factors had a significantly higher cavernous IMT.ConclusionsAn increased cavernous IMT (≥0.3 mm) might predict ED of vascular origin with more accuracy than PSV and could be a sensitive predictor also for systemic atherosclerosis at an earlier phase. Caretta N, Palego P, Schipilliti M, Ferlin A, Di Mambro A, and Foresta C. Cavernous artery intima-media thickness: A new parameter in the diagnosis of vascular erectile dysfunction. J Sex Med **;**:**–**. |
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