Combined intracavernous injection and stimulation(CIS) has been applied in clinical settings to screen for organic causes of erectile dysfunction. Although dynamic infusion cavernosometry and cavernosography(DICC) has been accepted as the most
useful
diagnostic modality for venogenic impotence, standardizing the testing and its interpretation has been controversial because of the relatively high false-positive rates. Our aims were to determine the reliability of the CIS test and each
parameter
of
DICc in 42 impotent patients. The result of the CIS test were categorized as good, fair or poor, depending on the level of erection and its rigidity, duration an adequacy for sexual intercourse. In the patients with fair or poor responses, penile
duplex
doppler ultrasonography was performed to exclude an arteriogenic origin of their problem. Venogenic impotence was diagnosed by DICc when the patient met one or more of the following criteria: equilibrium pressure <90mmHg, maintenance flow
rate>40mL/min,
or rate of fail>1.5mmHg/sec. Six patients(14%) were found to have psychogenic, 23(55%) venogenic and 13(31%) mixed arteriogenic and venogenic impotence. According to the outcome of the CIS test, 8 patients(19%) were placed in the fair response
group and
the remaining 34 in the poor-response group.
The results of this test and the components of DICC did not correlate(P>0.05). However, the correlation between the CIS test res?t and the measures of venogenic impotence showed a positive predictive value of 85.7%. The correlations between each
component of the DICC and venogenic impotence were statistcally significant(P<0.02). Among the components of the DICC, the rate of fall demonstrated the highest sensitivity(100%) and specificity(80%).
Our results suggest that the CIS test alone was inadequate for the diagnosis of venogenic impotence, whereas the DICC, especially the rate of fall, is excellent, whereas if the CIS test result is combined with the DICC, expecially the rate of
fall,
it
may be a uesful and effective tool for the accurate diagnosis of venogenic impotence.
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