Penile Duplex Doppler Ultrasound

Utility of the ultrasound:

Penile Doppler ultrasound testing is an extremely useful investigation in erectile dysfunction (ED) and Peyronie’s Disease.

It is a sophisticated test to objectively measure the blood flow in and out of your penis. This test will give the doctor important information as to the nature of penile structure and function, both in the erect and non-erect state.

It can therefore help to identify the underlying cause of ED – i.e. the Doppler US can determine if there is an arterial problem (blood inflow), a venous leak problem (blood outflow) or both. Arterial disease in the penis diagnosed on this ultrasound, may be related to more diffuse arterial disease such as in the heart.

If you have Peyronie’s Disease it will also assess the nature of the plaque and scar tissue in the penis. This will help to determine if you are a candidate for certain therapies or operations. In addition, it will allow the doctor to assess your penile curvature directly.

How is the test done?

It involves the use of a specialised ultrasound to see inside the penis and to look at the internal structures, the arteries and the veins.

In order to get the maximum information, you will need some medication to give you an erection. This also simulates "real-life". This medication is injected by a tiny needle into the penis. The medication then works automatically over about 10 minutes. Depending on the condition of your penis, you may need more than 1 injection. This is the only part of the test which may be a little uncomfortable. Most men describe the sensation as "like a hair being pulled out the back of my hand". The whole process is over in about 3 seconds.

A/Prof Katz usually does the doppler ultrasounds for investigation of Peyronies disease.
Dr Glen Duns usually performs the doppler ultrasounds for investigation of erectile dysfunction.

Once the doctor has determined you have a satisfactory response from the injection, he will then assess for any deformities of the penis. If you have any curvature, indents or instability, the doctor will use a specially designed apparatus (goniometer) to measure these.

The Doctor will then perform the ultrasound and will identify and measure the arterial inflow, the venous outflow and the penile integrity. If you have any plaques in the penis, the doctor will also assess these under the ultrasound.

When will I get the results?

The results are available almost immediately. You are able to see the ultrasound screen as the doctor is doing the test. He will point out to you any significant findings. The Doctor will save the relevant images to your file and will then discuss with you in detail about the findings of the ultrasound and what the next step in management will be.

What are the risks of the test?

Combined, the doctors at MHM have performed 100's of these Doppler Ultrasound tests and have never seen a serious side effect. The biggest potential risk of this study is an erection which lasts for too long (called a priapism). This condition can cause damage to the penis. The Doctor has a strict protocol which means that you will only go home once the doctor has confirmed that the erection has subsided. Most commonly this occurs by the end of the management discussion, but rarely, you may need a "reversal injection" which will immediately cause the penis to lose the erection. This injection only takes about 2-3 seconds.

If you find the erection returns after you have left the clinic, and it is persisting for more than 30 mins, you must give the clinic a call or page the doctor on 1800 374 636.

How long will the ultrasound take?

You will be with the doctor for about 1 hour. This takes into account the injection, the ultrasound, the discussion of the findings and management plan. However, your total time at the clinic may be 1.5-2 hours.

How much will the test cost?

Although there is a Medicare rebate for the test, there will still be an out-of-pocket expense. For more information please contact the clinic.

Where is the test performed?

Although Men’s Health Melbourne has several locations, only the Collins Street clinic has a dedicated ultrasound suite with all the necessary equipment. Please remember that undercover parking is available on site for $15 for 2 hours for more information: www.menshealthmelbourne.com.au/how-to-find-us/