Radiological methods in the diagnosis of cavernous hemodynamic disorders in men with diabetes mellitus and erectile dysfunction
Background. Cardiovascular diseases and diabetes mellitus (DM) remain the main comorbidities in erectile dysfunction (ED), and endothelial dysfunction plays an extremely important role in the mechanisms of ED development. The purpose of the study is to investigate the role of the vascular factor in the pathogenesis of ED in men with DM and the possibility of early diagnosis of vascular disorders. Materials and methods. To study the blood flow, 45 men with DM and ED aged 22–58 years were examined. Penile Doppler ultrasonography was carried out using AlokaSSD 5000 ProSound (Japan) device at rest and in dynamics of transition to a rigid erection after administration of a vasoactive drug at the 5, 15, and 30th minutes. Results. Reduction of peak systolic blood flow velocity with increased indices of arterial wall tone and peripheral resistance is a consequence of microcirculatory disorders, tissue permeability observed in patients with DM. Decreased blood supply to the penis and slowing the washout of tracer in men with DM and ED established during the radionuclide angiography of the penis indicate microcirculation disorders in the cavernous bodies (microangiopathy). Conclusions. Minimally invasive specialized methods for the examination of patients with DM and ED allow us to obtain a physiologically adequate assessment of the overall degree of vascularization of cavernous bodies in the dynamics of erection, complement each other and make it possible to evaluate the phenomenon of erection by various objective indicators.
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