With age, men have certain delicate health problems. Many are ashamed to seek help from specialists. Currently, the vast majority of pathologies are successfully treatable. Ultrasound of the penile vessels is an accurate diagnostic method that allows you to carefully identify the structure of blood vessels, to identify various deviations that impede normal blood circulation in the male reproductive organ.
What is dopplerography?
The method of non-invasive (without surgical instruments) research using high-frequency sound waves based on the Doppler effect is called dopplerography in medicine. Its essence lies in the fact that ultrasound waves are reflected from moving objects with a modified frequency.
This method is used to diagnose various systems and organs of a person, including reproductive ones. Doscopy (ultrasound) of the vessels of the penis allows you to identify irreversible functional disorders of the venous and arterial channels. This method makes it possible to accurately and quickly determine the direction and causes of the disease.
Types of Dopplerography
Depending on the disease, the specialist prescribes a certain type of study. Accurate diagnosis allows you to prescribe the optimal course of therapy. The study is performed by two methods:
- Stream spectral dopplerography (PSD). The method helps to evaluate blood flow in large vessels. The results are displayed in graph form.
- Energy (ED). Using this technique, it is possible to evaluate blood flow in each vessel, even in those where the blood speed is very low. But the method does not allow to determine the direction of blood.
Modern equipment allows you to combine these methods.
There are several types of research.
- Duplex scanning combines conventional vascular ultrasound and penile vascular dopplerography. Using the technique, it is possible to determine with the greatest accuracy the studied elastic tubular formations: wall structure, lumen size.
- Color mapping - selection on the monitor using different colors of speed and direction of blood flow. This method in combination with duplex research is called triplex scanning.
- Three-dimensional dopplerography. Using the equipment, you can build a 3D volumetric model of the investigated vessel or organ. This technique has one significant minus - the pictures are taken “manually”. There is a high risk of distorted image due to the movement of the sensor at uneven distances.
Typically, this study is in addition to ultrasound of the penis and scrotum organs.
What the method reveals
Dopplerometry provides the opportunity to make the most accurate conclusion, and in certain medical cases relieves the man of the need to perform other, most dangerous invasive methods. Results are obtained immediately after the procedure.
During ultrasound of the vessels of the penis, the doctor evaluates the following characteristics:
- The ability of a tissue to absorb high frequency sound is echogenicity. If the indicators exceed the norm, this indicates the obliteration of the cavernous (erectal) tissue of the penis fibrous (cavernous fibrosis). If the indicators are lower, the cause of inflammation is in the structural unit of the penis, which contributes to an erection.
- Homogeneous texture of the spongy body. The mismatch with the norm indicates cavernous fibrosis, localized foci.
- The fullness of the protein shell of the penis. If in an unexcited state, the thickness exceeds 2 mm, and in an erection state above 0.5 mm - this indicates the presence of Peyronie's disease.
- Echogenicity of the protein coat of the penis. Deviation from generally accepted indicators can be the cause of the curvature of the organ, which is facilitated by the growth of fibrous tissue.
- The transverse length of the cavernous (cavernous) arteries. Clearance in a blood vessel exceeding 1.4 mm is considered a deviation. If the diameter is less than 0.2 mm, then the risk of atherosclerosis or autoimmune diseases is high.
Who needs research
Dopplerography is prescribed for patients who refuse to diagnose pathologies of the reproductive organs using invasive methods. Indications for making an ultrasound of the vessels of the penis can be various pathologies or damage, namely:
- An erection dysfunction characterized by insufficient hardness to perform a sexual act.
- Curvature of the genital organ due to fibrotic changes - Peyronie's disease.
- Damage to the soft tissues of the penis, bruises, violation of integrity.
- Benign and malignant neoplasms.
- The appearance of scars, hematomas due to pathologies of blood supply to the cavernous bodies.
- Structural changes in the urethra.
- Diseases characterized by the deposition of cholesterol on the inner wall of the vessels of the penis.
- Varicocele is an aneurysm-like local dilation of the veins of a cord located in the inguinal canal.
Dopplerometry can be prescribed before the planned surgical operations on the organ.
In what cases is the procedure contraindicated
Features that prevent the use of ultrasound of the vessels of the penis are unconditional and relative.
Absolute:
- violation of blood circulation due to the formation of a blood clot in the lumen of the vessel;
- abnormalities of the hemostatic system;
- diseases of the urinary system caused by pathogenic microorganisms.
Relative contraindications are damage to the genital organ, in which touching it causes pain to the patient. It is not recommended to conduct a study if complications can occur due to stimulants of an erection: stroke, heart attack.
Preparation for the procedure
The rules for preparing the patient for dopplerography are almost the same as for ultrasound of the scrotum and penis.
- 48 hours before the procedure, the consumption of alcoholic beverages is prohibited.
- In 30 minutes - urinate.
- Before visiting a specialist at home, conduct standard hygiene of the organs examined.
- It is forbidden to take vascular preparations immediately before the procedure.
Doctors advise a few days before the procedure to avoid stressful situations, physical exertion and abstain from sexual contact whenever possible.
For the objectivity of the assessment requires an increase in volume and hardening of the penis. Accelerate the onset of erections with the help of injections of Alprostadil, Papaverine or Kaverzhekt drugs. If desired by the patient or for some other indicators, injections can be replaced with tablets.
Due to artificial stimulation, the patient may experience discomfort, and sometimes mild pain.
How is the procedure
An ultrasound of the penis can be done by an andrologist or urologist. The speed, direction, intensity of blood flow in the vessels is fixed during an erection and at rest. The process takes several steps and takes about 30 minutes.
- The patient lies on the couch after removing his underwear. The specialist applies the gel to the examined area and installs a special sensor in the form of a turnstile. An erection stimulating drug is injected into one of the cavernous bodies.
- Take readings when the penis is at rest. A review of the walls of blood vessels, lumen of the arteries, measurements of the protein coat.
- The blood flow is sequentially recorded in the phases: filling, swelling, tumescence, rigidity, detumescence.
- After the drug is administered, blood flow measurements are taken every 5 minutes for half an hour.
After the procedure, you can remove the excitement by self-stimulation of the genitals in a special separate room. If the volume and hardening of the organ within 4 hours does not decrease, urgent consultation of a specialist in the field of andrology is necessary.
Interpretation of Results
Indicators are evaluated immediately after ultrasound of the penis. The doctor does an analysis of the characteristics.
- Peak systolic (moment of blood ejection) speed. The following indicators are considered the norm: the genital organ at rest - 15-25 cm / s, the filling phase - 35 cm / s. Lower rates indicate arterial insufficiency.
- Diastolic (vascular relaxation moment) speed. Norm: 0 cm / s at the moment of calm, 10 cm / s - peak of excitement.
- The Gosling Index is above 4.
- The resistance index (RI) is normally: the resting phase - 0.8; filling phase - 0.7; erection - 1.
With stable excitation caused by drugs, the outflow of blood stops, if not, an erection dysfunction is diagnosed.
Advantages of genital dopplerography
The study makes it possible to establish the factors and nature of the pathology. In addition, there are a number of reasons why it is worth using this particular diagnostic method.
- The procedure is safe, it takes place without violating the anatomical integrity.
- It does not produce unnecessary consequences and does not worsen the course of the disease.
- The study is very fast, and you can immediately get the results.
- It does not require special training.
- Diagnosis can be carried out in any medical center of each city.
Disadvantages of the procedure
The main disadvantage of the method is the mandatory use of drug stimulants of erection. For many, this is accompanied by emotional discomfort and pain due to an injection and a sharp arousal.
Stress can cause an increase in pressure. As a result, there will be a convulsive contraction of the cavernous arteries and an increase in volume, and hardening will be insufficient or not at all. Therefore, before the procedure, the specialist conducts a conversation with a detailed explanation of the necessity and essence of the technique.
Where do the research
Due to the delicacy of the problem, most men simply do not know where to do an ultrasound of the penis. Diagnostics can be carried out free of charge in a regular clinic. To do this, you will need a compulsory medical insurance policy and a referral from a doctor, to whom you must get an appointment before.
On a paid basis, dopplerometry can be done at any medical diagnostic center. The price segment, of course, is different: for example, ultrasound of the penile vessels in Nizhny Novgorod will cost less than in St. Petersburg.
Dopplerography does not require special preparation, but it has certain specifics and aspects. The study is completely harmless, the procedure is quick and almost painless and provides accurate and detailed results.