A penile Doppler ultrasound is a specialized test that uses sound waves to evaluate the blood vessels in the penis. Healthy erections depend on blood flowing quickly into the penis and being temporarily trapped there. If the arteries are narrowed or if the veins leak blood too quickly, it can cause erection issues.
To evaluate these vessels, a medication is injected into the side of the penis during the scan to stimulate an erection. The Doppler ultrasound then measures the speed of blood flow before and after the injection.
Common Indications for a Penile Doppler Ultrasound
- Investigating erectile dysfunction (ED) that does not respond to standard oral medications.
- Checking for a venous leak (when blood drains too quickly from the penis during an erection).
- Evaluating scar tissue or curvature of the penis (Peyronie's disease).
- Checking the blood vessels after trauma or injury to the pelvic area or groin.
- Investigating prolonged, painful erections (priapism).
What exactly does a penile Doppler ultrasound show?
The scan shows the size and health of the penile arteries and measures the peak speed of blood flow entering the penis. It also shows if there is scar tissue or plaque inside the penile structures and checks if the veins are leaking blood back into the body too quickly.
How should I prepare for a penile Doppler ultrasound?
No fasting is required. You should avoid taking any erectile dysfunction medications (such as Viagra or Cialis) for at least 24 to 48 hours before the scan. Wear loose, comfortable clothing that is easy to remove.
Do I need to stop taking medication?
No, except for ED medications as noted above. Continue taking your other prescribed medications, such as blood pressure drugs. Inform the team if you are taking blood thinners.
What happens when I arrive for my scan?
You will go to a private scan room. To ensure your privacy, only the doctor and radiographer will be present. You will be asked to undress from the waist down and lie on your back on a scan couch.
How is the procedure performed?
The doctor will perform an initial ultrasound scan of the flaccid penis. Then, they will inject a small dose of vasoactive medication (which opens blood vessels) into the side of the penis using a very fine needle. The injection feels like a small pinch. Over the next 15 to 20 minutes, the doctor will apply gel and run the Doppler probe over the penis at regular intervals to measure blood flow as an erection develops.
How long does a penile Doppler ultrasound take?
The procedure takes about 30 to 45 minutes. This includes the time needed for the injection medication to take effect and to take multiple blood flow measurements.
Is there any discomfort?
You will feel a brief sting from the injection needle, which is very thin. The ultrasound probe itself is painless. You will feel a firm erection develop, which may feel slightly tense or warm.
Are there risks?
Yes, but they are rare. The main risk is a prolonged erection (priapism) lasting more than 4 hours. If your erection does not go down after a few hours, you must return to the clinic or go to an emergency room, where the doctor can easily give a reversing injection. There is also a very small risk of bruising or minor bleeding at the injection site.
Can children have this scan?
This scan is almost exclusively performed on adult men.
Can I have this scan if I am pregnant?
This scan is only performed on male patients.
When will I get my results?
The doctor will calculate the blood flow velocities during the scan. A report with the measurements will be sent to your referring doctor or handed to you within a few hours.
What if the scan finds something?
If the scan identifies a blood flow issue (like arterial narrowing or a venous leak), your referring doctor (usually a urologist) will discuss targeted treatments. These may include specific medications, injection therapy, or surgery.
Conclusion
A penile Doppler ultrasound is the gold standard for diagnosing the physical causes of erectile dysfunction. To make the procedure easier, try to relax, and remember to seek immediate medical help if your erection lasts longer than 4 hours after the test.