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Question
I have a question regarding the accuracy of penile doppler ultrasound in the detection and diagnosis of venous leak.

Penile doppler results of my brother showed persistent reversed flow EDV along the course of the examination. Is it still possible for him to be suffering from venous leak?

In other words, is it possible if he undergoes cavernosometry that it will reveal venous leak?

Or does the "Reversed flow EDV" pattern excludes the possibility of venous leak altogether?

Thanks in advance.

Answer
Hani:

Unfortunately, regardless of the EDV, there is still the possibility of venous leak although usually this is unlikely as the EDV decreases.  Doppler ultrasound is just not accurate enough to be guaranteed.

But why does he need to know?  There is essentially no reliable treatment specifically for venous leak and the available therapies remain the same.  Why go through the discomfort and expense of cavernosometry when it provides no likely therapeutic benefit?

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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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