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Question
soo during my penile test at once point it showed my edv to be 9 but then just one minute later it showed it to be 7. also i was given a really low dose 15mg of trimex. my question is it reasoanble to believe that my number would of gone lower if he would of measured it a little later and i also was reading that a small dosage causes an increase in edv. is this true?

Answer
Sean:

First, there is no such thing as "15 mg of trimix".  Since trimix is a mixture that does not have a definitive standard composition, the dosage is measure by the concentration that makes it up and the volume given. Therefore, there is no way to interpret what 15 mg of trimix is.  In other words, if your formula for trimix is 30 mg of paperverine, 5 mg of regitine and 10 mcg of prostaglandin, how much is 15 mg of the mixture?  Trimix is not usually used for this testing because of this issue and the potential for prolonged erections.

These medications are designed to relax smooth muscle tissue and increase arterial flow.  End diastolic velocity is a measurement of the spped of blood flow at the end of the heartbeat.  since at this point there is minimal pressure, the flow should be low.  A high EDV would indicate a possible venous leak.  Since the purpose of the doppler is to diagnose arterial flow and the issue about venous leak is a secondary concern, once an adequate arterial flow is found the procedure is usually terminated.  Once there is verification of a good blood arterial blood flow, it is not recommended nor appropriate to increase the medication dosage just to try to demonstrate a lowering of the EDV.

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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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