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Urology/penile doppler test

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QUESTION: I was given a super low dosage penile doppler test, is it still accurate.

I asked another urologist on here and he said this
"Passing the test with out an erection contradicts physics. When you are given a low dose as a result of being young and healthy and the medication is not effective a second dose must be administered to the contralateral artery. This sounds like the examiner does not know what they are doing if it was deemed normal and you were semi erect. I think your duplex should be re-done by someone registered with the ARDMS that has trained in penile duplex. The last urologist I saw perform a duplex did it completely wrong, so I am not surprised. This is like me being a radiology technologist doing kidney surgery after watching a few cases in the OR. Unfortunately doctors get to work outside the scope of their expertise with out accountability. I do not like criticizing other professionals ,but I can not concur with the diagnosis. "



IM REALLY SCARED I DIDNT PASS NOW

ANSWER: Mike:

I do not agree.  Using a low dose for a penile doppler test on a young man is not unreasonable.  You are looking for several things with the test.  One is the clinical response which you clearly had.  The other is the response of the cavernosal arteries to the medication.  If this response is significant and the blood flow has increased, I do not see where it is necessary to take the risk of a prolonged and painful erection by increasing the dose.  This can certainly happen and it could be argued that your urologist was being cautious after concluding that your arterial and clinical response to a deliberately low dose was sufficient to show good vascularity which is all the test is supposed to determine.

---------- FOLLOW-UP ----------

QUESTION: that makes sense but the other person i asked was thomas suppe on this site. Apparently he is RDMS and specializes in penile dopplers so thats why his response scared me. I know this question could be seemed offensive, but are you more qualified to answer this question then him. I used this test to allievate all fears of venous leak and have been very calm for a while but after reading that not having a full erection makes the test invalid im worried. Also he said that a lot of them hold the scanner perpindicular giving it a false reading.... All I know is he says hes been doing these tests for long time and that not having a full erection or low dose means I can still have a venous leak.


Thank you for your time, im kind of a hypochondriac so these answers really help me

Answer
Mike:

I've been doing the tests for a long time too, but I don't claim to be a super specialist in this area.  Let's look at it another way.  The results don't really matter because all that matters is how well your doctor can help you get an erection.  If viagra or injections work, then the results of this test are meaningless.  We rarely do these tests anymore because we find it doesn't help as we tend to focus more on using things that might help like viagra, vacuum systems, injections or MUSE.  Regardless of passing or failing the test, we are still left with the same choices for therapy so focus on the end result and stop driving yourself crazy about the results of a test that won't change anything.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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