THE DIAGNOSTIC ROLE OF CAVERNOSOMETRY, CAVERNOSOGRAPHY AND CC-EMG IN PATIENTS WITH ERECTILE DYSFUNCTION DUE TO EXCESSIVE CAVERNOUS OUTFLOW

Venous leakage was suspected in 155 patients with erectile dysfunction. In 27 patients with primary and 128 patients with secondary erectile dysfunction, pharmacocavernosometry and -graphy was done. 21/27 (78 %) and 105/128 (82 %) patients showed venous leakage as (concomitant) etiology of impotence. 17/21 (81 %) and 52/105 (49.5 %) presented with pathologic cavernosal drainage via a single venous system; 4/21 (19 %) and 53/105 (50.5 %) patients showed combined venous leakage. Maintenance flow increased with age in the group with secondary impotence, however this finding was not statistically significant. The rate of maintenance flow corresponded to the erectile response to a standardized intracavernosal injection of vasoactive drugs. The type of leakage corresponded well to the maintenance flow when the single drainage type was compared to combined drainage. Also, the type of leakage corresponded to the response to intracavernosal pharmacotesting. Corpus caveraosum EMG (Single Potential Analysis of Cavernous Electric Activity = SPACE) did not correlate to maintenance flow or to the response to intracavernosal injections. 66/126 (52.4 %) patients with venous leakage and 12/29 (41.4 %) patients without leakage had abnormal CC-EMG findings. 16/29 (55.2 %) patients had a poor response to pharmacotesting despite the absence of venous leakage. Of the 16 patients, 13 (81.3 %) had an abnormal CC-EMG. These findings suggest that CC-EMG has no significant correlation with cavernosometry, Thus, CC-EMG contributes diagnostic information independent of the venoocclusive function measured by cavernosometry.