Comprehensive assessment of cavernosography with 320-row dynamic volume CT versus conventional cavernosography in erectile dysfunction patients caused by venous leakage

Abstract

The present study aims to investigate and compare the diagnostic and prognostic value of cavernosography with 320-row dynamic volume computed tomography (DVCT) versus conventional cavernosography in men with erectile dysfunction (ED) caused by venous leakage. A total of 174 patients diagnosed with ED were enrolled and received cavernosography with 320-row DVCT (DVCT group) and conventional cavernosography scans (control group) respectively. The diagnosis, complications, and prognosis of patients were evaluated. The DVCT group provided high-resolution images with less processing and testing time, as well as lowered radiological agent and contrast agent compared with the control group. In the DVCT group, 89 patients who were diagnosed with venous ED had six various venous leakage, namely superficial venous leakage, profundus venous leakage, the mixed type, cavernosal venous leakage, crural venous leakage, and also venous leakage between the penis and urethra cavernosum (9, 21, 32, 6, 18, and 3 cases respectively). Similarly, 74 patients out of the 81 who suffered from venous ED were classified to have superficial venous leakage (11), profundus venous leakage (14), the mixed type venous leakage (26), and middle venous leakage (23). Six out of 25 patients in the DVCT group, had improvements in ED while the remaining 19 achieved full erectile function recovery with no penile fibrosis and erectile pain. Cavernosography with 320-row DVCT is a reliable system that can be used to diagnose ED caused by venous leakage. This is especially useful in accurately determining the type of venous and allows for a better prognosis and direction of treatment.

Keywords: 320-row DVCT cavernosography; Conventional cavernosography; Diagnostic and prognostic value; Erectile dysfunction; Venous leakage.

Figure 1. Image of corpora cavernosum detected by the cavernosography with 320-row DVCT compared with an image taken by conventional cavernosography

(A) Cavernosography with 320-row DVCT image of regular cavernosa by; (B) cavernosography with 320-row DVCT image of cavernosal venous leakage by; (C) conventional cavernosonography image taken of the regular cavernosa by; (D) conventional cavernosa image of the cavernosal venous leakage by DVCT.

Figure 2. Venous leakage of corpora cavernosa scanned by cavernosography with 320-row DVCT

(A) Superficial venous leakage; (B) profundus venous leakage; (C) crural venous leakage; (D) cavernosal venous leakage; (E) venous leakage between the penis and urethra cavernosum; (F) mixed venous leakage.

Figure 3. Venous leakage of corpora cavernosa scanned by conventional cavernosography

(A) Type I: superficial venous leakage (imaging of left external iliac vein); (B) Type II: middle venous leakage (imaging of corpora cavernosum urethrae and glans penis); (C) Type II: middle venous leakage (imaging of right internal iliac vein); (D) Type III: profundus venous leakage (imaging of deep veins of penis and internal jugular vein); (E) Type IV: mixed leakage (imaging of left internal iliac vein, deep veins of penis, and internal jugular vein); (F) Type IV: mixed leakage (imaging of left internal iliac vein, glans penis, deep veins of penis, and internal jugular vein).