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The efficacy of penile duplex ultrasound in erectile dysfunction management decision-making: facing the opinion leader
1University of human health sciences of Florence, 50134 Florence, Italy
2University College London Hospitals NHS Foundation Trust, NW1 2PG London, UK
3St. Peter’s Andrology Centre, W1G 6AA London, UK
4University Medical Center Schleswig-Holstein, 24105 Kiel, Germany
5University of Foggia, 71122 Foggia, Italy
6Center for Genito-Urinary Reconstructive Surgery, RF25+4V Belgrade, Serbia
7Antonini Urology, 00185 Rome, Italy
8Rush University Medical Center, Chicago, IL 60612, USA
9Puerta de Hierro-Majadahonda University Hospital, 28222 Madrid, Spain
1012 de Octubre University Hospital, 28041 Madrid, Spain
11Egydio Medical Center, 04552-040 São Paulo, SP, Brazil
12Hospital Sanitas La Zarzuela, 28023 Madrid, Spain
13‘Martha-Maria’ Hospital Nuremberg, 90491 Nuremberg, Germany
14Perito Urology, Coral Gables, FL 33146, USA
15Clinique Saint-Roch, 34000 Montpellier, France
16Pusan National University School of Medicine, 49241 Busan, Republic of Korea
17Medical Research Institute of Pusan National University Hospital, 49241 Busan, Republic of Korea
18Molinette University Hospital, 10126 Turin, Italy
19Istanbul University İstanbul School of Medicine, 34093 İstanbul, Turkey
20Fundació Puigvert, 08025 Barcelona, Spain
21Jessa Ziekenhuis, 3500 Hasselt, Belgium
22The Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
23Institute for Urologic Excellence, La Quinta, CA 92253, USA
24Hospital da Luz Arrábida, 4400-346 Porto, Portugal
25University of Naples Federico II, 80138 Naples, Italy
DOI: 10.22514/jomh.2024.084 Vol.20,Issue 6,June 2024 pp.8-11
Submitted: 28 December 2023 Accepted: 29 February 2024
Published: 30 June 2024
*Corresponding Author(s): Andrea Cocci E-mail: andrea.cocci@unifi.it
Erectile dysfunction (ED) poses a significant challenge in clinical practice, necessitating accurate diagnostic strategies to distinguish between organic and psychogenic causes. Current guidelines advocate a comprehensive approach involving medical history, physical examination and blood tests, with second-level analyses like the intracavernous injection of vasoactive drugs (ICI test) and penile duplex ultrasound (PDU) reserved for specific cases. A survey involving 24 urologists experienced in ED was conducted to assess their opinions on the appropriateness of the ICI test and PDU in six clinical scenarios. Results were analyzed using pie charts, revealing varied preferences among experts. The responses indicated diverse viewpoints, with preferences for the ICI test or PDU depending on the patient’s age, comorbidities, response to phosphodiesterase type 5 inhibitors (PDE5i) and concomitant Peyronie’s disease. In some cases, a significant proportion of experts opted for neither test. The study highlights the lack of consensus among experts regarding the routine use of PDU in ED management. Despite its diagnostic capabilities, the clinical utility of PDU remains unclear, and its role may be more justified in certain populations with anatomical abnormalities or specific conditions. The need for rigorous research to determine the impact of PDU on ED management decision-making is emphasized.
Erectile dysfunction; Penile duplex ultrasound; Intracavernous injection
Andrea Cocci,Marta Pezzoli,Mattia Lo Re,David Ralph,Nim Christopher,Daniar Osmonov,Carlo Bettocchi,Rados Djinovic,Gabriele Antonini,Laurence Levine,Juan Ignacio Martínez Salamanca,Javier Romero Otero,Paulo Egydio,Ignacio Moncada Iribarren,Georgios Hatzichristodoulou,Paul Perito,Faix Antoine,Hyun Jun Park,Luigi Rolle,Ateş Kadıoğlu,Eduard Ruíz-Castañé,Koenraad Van Renterghem,Robert J Valenzuela,Steven K Wilson,Nuno Tomada,Marco Capece,Marco Falcone. The efficacy of penile duplex ultrasound in erectile dysfunction management decision-making: facing the opinion leader. Journal of Men's Health. 2024. 20(6);8-11.
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