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A Dual-Radioisotope Technique for the Evaluation of Penile Blood Flow During Tumescence

Division of Nuclear Radiology, Department of Radiology and University Hospitals of Cleveland, CWRU, School of Medicine, Cleveland, Ohio

Correspondence: For reprints contact: Floro Miraldi, MD, ScD, Director, Division of Nuclear Radiology, University Hospitals of Cleveland, 2074 Abington Rd., Cleveland, OH 44106.

ABSTRACT

A technique is described for concomitant study of both arterial and venous penile blood flow during tumescence. Dual-isotope acquisition is started after labeling red cells in vivo with ^99mTc. Xenon-133 in saline is then injected into the corpus cavernosum followed with vasoactive drugs to induce an erection. The resulting xenon and technetium time-activity curves are inputs for a one-compartment model. In 14 subjects, the average peak arterial flow rate (PAF) for normal males was calculated as 13.0 ± 1.28 ml/min (avg ± s.d.) compared to 16.1 ± 5.14 and 5.02 ± 178 ml/min for patients with venous leak (VL) or arterial insufficiency (Al), respectively. Peak venous flows (PVF) were 4.25 ± 1.17, 12.1 ± 3.75, and 3.78 ± 1.00 ml/min for normal, VL and AL respectively. Al patients have significantly lower PAF than normal (p = 0.002) or VL patients (p = 0.018), and VL patients had significantly higher PVF than normal (p = 0.012) or Al (p = 0.018). The technique may be helpful in the study of impotence.