(UroToday.com) Dr. Federico Zorzi presented his research on the potential of arteriogenic insufficiency assessed by penile doppler ultrasound as a predictor for major cardiovascular (CV) events in arteriogenic refractory erectile dysfunction (ED) in response to prostaglandin.
Dynamic color Doppler ultrasound (CDU) is a gold standard tool used to evaluate penile vascular function for patients with ED. CDU hemodynamic measurements may assess more than just ED, as past literature has identified ED as a potential indicator of CV disease. Consequently, Dr. Zorzi aimed to elucidate the potential predictive correlation between CDU-assessed arteriogenic insufficiency and CV events.
279 patients who were confirmed to have refractory ED to PDE5-I therapy were injected with 10 µg of prostaglandin before undergoing CDU evaluation. Patients were categorized as having arteriogenic insufficiency when peak systolic velocity (PSV) was below 35 cm/s (34 patients). The age, BMI, and 10-year atherosclerotic cardiovascular disease (ASCVD) risk score of each patient were recorded. Univariate and multivariate logistic regression models analyzed the predictive correlation between the ASCVD risk score and arteriogenic ED. A Kaplan-Meier curve analyzed the probability of CV event occurrence over time of patients with and without an impaired PSV.
Dr. Zorzi found that patients with an impaired PSV had a significantly higher age, BMI, and ASCVD risk score than those with normal PSV, as shown in the table below.
Additionally, ASCVD risk score multivariate logistic regression analysis found that a higher ASCVD risk score was independently associated with arteriogenic ED, with an odds ratio of 1.1 and area-under-the-curve score of 0.88 as displayed in the figure below.
Lastly, the 9 patients were found to have a CV event at a median follow-up time of 53 months, with a significantly higher probability of CV events occurring in patients with PSV impairment, as illustrated below.
Dr. Zorzi concludes his presentation with the statement that an impaired PSV as measured on a CDU is a predictor of CV events in patients with PDE5-I refractory ED; therefore, CDUs of patients with ED can help with CV preventative measures.
At the end of the session, an audience member asked if Dr. Zorzi measured patient blood pressure before undergoing penile doppler in his clinic, to which he responded that patients are screened through the cardiology department beforehand.
Presented by: Federico Zorzi, MD, University of Trieste, Trieste, Italy
Written by: Victor Pham, BS, University of California, Irvine, @victorpham01 on X during the American Urological Association's 2025 Annual Meeting, between April 26 – 29, 2025 in Las Vegas, NV.
References:
- Aversa A, Bruzziches R, Spera G. Diagnosing erectile dysfunction: the penile dynamic colour duplex ultrasound revisited. Int J Androl. 2005 Dec;28 Suppl 2:61-3. doi: 10.1111/j.1365-2605.2005.00587.x. PMID: 16236067.