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Question
I understand your getting annoyed by my questions, but im a kid who needs closure and i just want to confirm this with you so (ive made a promise to never ask another question after this). Now, if my technician measured one time ever and saw i didnt have a leak then hes supposed to stop then right? or is he supposed to keep measuring it to compare the rapid changes if he thinks the measurement was close to a leak? Also does it matter if they only wait under 10 minutes to start the measuring?

I really apprieciate your questions and its been  really helping me mentally. The problem I have is that I read stuff on the internet and other professors who claim my tests arent valid. Thank you again sir

Answer
Mike:

The purpose of the doppler test is not just to determine if there is evidence for a venous leak.  Frankly, we would not do the test for that purpose alone as there is no specific treatment for venous leak so making the diagnosis is of no practical value.  The reason we do the test is two fold:

First, to determine the arterial blood flow after smooth muscle relaxation.  To do this, we give an injection of smooth muscle relaxing medication to simulate what happens during a normal erection.  We measure the blood flow in the arteries before and after the injection.  If the arterial blood flow increases beyond the minimal threshold, then we can determine that there is no arteriogenic component to the ED.  This is helpful in deciding on the various treatments.

Second, we look at the clinical response to varying dosages of medication as we can use this as one alternative treatment option.

The fact that we can also get a reading that can help diagnose venous leakage is incidental and not a critical part of the testing.

Next, in my opinion, it is OK to wait less than 10 minutes to do the first measurement.  I've answered the point about frequency of measurements before.

If other experts recommend a different sheme, that's up to them.  You asked for my opinion.  Now you have to decide who to believe.  I repeat my earlier statement that it is the value of the measurements that is significant rather than any strict adherence to a schedule or timing protocol.

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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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