Analysis of the relationship between sexual satisfaction, erectile dysfunction, and penile vascular parameters in a cohort of patients

BACKGROUND: Erectile dysfunction (ED) is the second sexual dysfunction affecting men. Penile duplex ultrasound (PDU) with intracavernous injection of a vasoactive agent as alprostadil or papaverine, may play an important role in differentiating psychogenic from vasculogenic ED (arterial or venooclusive) and may also have an important role in the secondary prevention of cardiovascular events. The aim of this study is to investigate the relationship between the vascular parameters and sexual satisfaction as established by a questionnaire. METHODS: Prospective, multicenter analysis of all patients who underwent a PDU between September 2018 and April 2021 in four centers, including patients who were >18 years old and underwent a PDU for ED, Peyronie’s disease (PD) or other reasons, signed informed consent and completed an adapted version of the Brief Sexual Symptom Checklist (BSSC). All the patients underwent a standard technique, and from a total of 325 patients, 16 were excluded because of low testosterone levels, and 15 due to missing data, RESULTS: A total of 294 patients were included for the analysis. Significant differences were found between patients with and without ED defined by their score in the Sexual Health Inventory for Men (SHIM) questionnaire in the PSV at 10’, adjusted for age (38.07 vs. 44.95 cm/s; P=0.016), and in the PSV and the EHS at 10’ for sexually satisfied and non-satisfied patients, and a significant correlation with those parameters and the probability of being sexually satisfied (r=0.147, P=0.011; r=0.132, P=0.023; respectively). CONCLUSIONS: In our clinical practice we used the cut-off of >35 cm/s, that seems to be quite low looking at our results. The 10’ measurement may be more sensitive in order to establish a diagnosis. BSSC questionnaire is a simple, easy-to perform tool to screen those patients at risk of developing sexual dysfunctions.