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Urology/penile doppler


QUESTION: I was givin a penile doppler test with a very very low dosage. It barley got me erect, but they measured the blood flow and concluded that I was fine. Does this mean i am fine or is this low dosage matter?

If you can give me the data off the report I can tell you if the numbers show you were normal. If you do not get a full erection during the duplex then either the dose is too low for you or you have ED via arterial insufficiency or venous leak. There are many problems with how a penile duplex study is performed that can give a false positive. The biggest problem I have seen is examiners scanning the cavernosal artery in the transverse scanning plane. This is when the linear probe is perpendicular to the penis , this causes the Doppler signal to pick up the turbulence of the blood flow in a tumbling motion subsequently increasing the velocity and giving a false peak systolic number. When the scan is done in the sagittal or longitudinal plane the signal hits a broad stable wall of movement VS a small cross section. The other mistake made is when the Doppler angle is not set between 55-65 degrees and affixed correctly to the vessel in a linear fashion. This is difficult for the average non sonographer to comprehend so its best to say proper technique is paramount to a true Doppler evaluation and accurate diagnosis. If the numbers say normal and there is not a good erection sufficient for penetration then technique can be a probable a factor. Send me the data and I will let you know.

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QUESTION: It was a while ago but it was just to allievate my worries. They gave me a low dose cause im healthy male and it showed that the blood flow was good. Other doctors on this site including the urologist I used said im fine.  If it changes anything later that day I got a huge erection.

If you got a huge erection later that day its likely adrenaline in the doctors office played a big role in your poor erection. Sounds like your OK.

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QUESTION: however during the test i barley had a semi, but i still had blood flowing and it showed that it wasnt leaking. doesnt that mean im fine, like why do you need a full erection to measure blood flow of a leak?

You can not have a flaccid penis when blood flow is occluded. There is a serious problem with your test and interpretation if you were classified normal with a flaccid or semi flaccid (plump) penis. Passing a duplex with a normal diagnosis requires peak systolic velocities above(PSVs)of 25> cm/s  and end diastolic velocities (EDVs)of less than <5 cm/s  with a 75% erection sufficient for penetration. If your penis is soft that means there is circulation and erections have little to no circulation at all. This is like saying a balloon is full of air but has a hole in the side of it. The penis is a blood balloon persay and unless its sealed one can not get an erection. Go to a different urologist that has studied ultrasonograhpy and color flow duplex Doppler. They either are shining you on or are not trained at sonography. Take it from someone who teaches physicians this form of radiology I am paid to do this and would not steer you wrong. Not all physicians are up to par when it comes to diagnostic radiology because very few residency programs have a uro-radiology program as we do here at Baylor College of Medicine. If you need a recommendation of someone in your area I may be able to help.  


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Thomas A Suppe RDMS CLT


Invervential urologic radiology , urologic laser surgery, cryotherapy of the prostate and kidney, extracorporal shockwave lithotripsy, holmium laser lithotripsy, urodynamics (video-non video),male infertility, erectile dysfunction, Peyronies disease, hypogonadism ,kidney stones, prostate cancer detection, BPH, voiding dysfunction, bladder cancer and continent diversions.


For the past 20 years performing intervential and diagnostic uro-radiology for a multitude of urologic surgeons from New York, New Jersey, Lousianna and Texas. Founder of DMS medical LLC introducing the Texas Medical Center to the first high power Green Light laser for the treatment of BPH just after its release by the FDA from Laserscope and its sucessful trials at the Mayo Clinc.

American Registery of Diagnostic Medical Sonographers (ARDMS), American Urologic Assocoation (AUA), American Medical Systems (AMS) Laserscope,Oncura, Allergan and Auxilliam pharmaceuticals.

Comprehention of Urologic Ultrasonography for the Resident Physician (Journal of Urology 2012), Author of the syllabus for the uro-radiology residency course at The Scott Dept of Urology at Baylor College of Medicine Houston Texas (2010 to present). Past Clinical Studies: Principal radiology investigator Allergan Inc for "The treatment of BPH with intra-prostatic injections of Botox" with Larry I Lipshultz MD 2011-2012, principal radiology investigator for Allergan Inc for "The treatment of Peyronies disease by intra-lesional penile injections of Botox" with Mohit Khera MD MBA MPH (2011-2012). Current studies: Principal investigator of "Blood pressure risk factors of intra cavernosal injections of Trimix and PGE1 during Penile Duplex's.

BS from Ramapo College of NJ, Registered diagnostic medical sonographer with the ARDMS, 2 year fellowship of Uro-Radiology and intervential sonography at Baylor College of Medicine Houston TX, laser safty officer in state of Texas and certified in KTP, Holmium and Lithium Tri-boride laser systems from Laserscope San Jose, California and American Medical Systems Minnatonka Minnasota, trained and certified by Oncura Inc Isreal in ultrasound guided argon cryotherapy of the prostate and kidney.

Awards and Honors
Honorary instructor of GU ultrasound course 2012 international meeting of the American Urologic Association. Author of the the AUA course for "Ultrasonography of the Testes and Scrotum" 2012.

Past/Present Clients
Baylor College of Medicine (BCM) Lousianna State University (LSU), LSU Medical Center Shreeveport LA, The Methodist Hospital Houston Texas, St Lukes Episcopal Hospital Houston Texas, Memorial Herman Health Systems Houston Texas, Palestine RMC Texas, Doctors Regional Hospital Corpus Christi Texas, Valverde Regional Medical Center DelRio Texas, Current instructor/technologist for two internationally recognized urologists : Larry I Lipshultz MD and Mohit Khera MD, MBA, MPH at Baylor College of Medicine. I served as intervential sonography consultant for Oncura Inc cryotherapy systems. Former lead trainer for Urosource mobile medical services , training new surgeons in PVP or photo-selective vaporization of the prostate for BPH, BNCs and urethral stricture vaporization.

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