Non invasive detection of venogenic impotence: real-time US evaluation of periprostatic (Santorini's) venous plexus after (PGE1) induced erection.

The diagnosis of venous impotence is actually reached through cavernometry and cavernography. These procedures are somewhat painful, invasive, time consuming and not always free from side effects. Anatomo-physiological studies have assessed connections between periprostatic (Santorini's) plexus and deep venous drainage of the penis. Moreover, dilated periprostatic plexus is a common ultrasound finding in the phlogistic pathology of the prostate and it is often the cause of temporary functional impotence. 20 Patients suffering from venous impotence, previously assessed by flow/pressure studies, underwent real time transrectal scan (Kretz Combison 330 equipped with 7.5 MHertz multiplanar probe) before and after Prostaglandins E1 (PGE1) (Prostin VR-Upjohn) induced erection recorded by computerised rigidometer (RigiScan-Dacomed). Dilated periprostatic venous plexus associated with tumescence or unstable valid erection ("tooth-saw-trace") was considered diagnostic for venogenic impotence. Real time ultrasound evaluation after PGE1 induced erection is to be considered a reliable method in the qualitative assessment of venogenic impotence. The procedure allows, moreover, a more accurate urologic assessment and is also useful in the early detection of various prostatic disease which are, like erection disorders, often age-related. Customary diagnostic procedures (cavernometry and caverography) may represent a second-line or pre-surgical assessment policy.