Obligatory medical device diagnostics.
- Penile ultrasonography (ultrasound examination of the penis) [detection of plaques in number and size (echo-rich thickening of the tunica albuginea (connective tissue sheath around the corpora cavernosa)); calcified or not yet calcified: calcifications (calcifications) in the plaque area can be identified by the dorsal acoustic shadow]
- Doppler sonography (ultrasound examination that can dynamically visualize fluid flow (especially blood flow)) – visualization of the penile arteries with a color Doppler or a duplex device and measurement of the so-called peak systolic velocity (PSV) and end-diastolic velocity (EDV), as well as the vascular resistance index (RI) in the A. penis profunda (penile artery) [low PSV (< 28 ± 4 cm / s): arterial insufficiency / arterial circulatory disorder likely; high EDV (> 5 cm / s): suspicion of venous leakage]If necessary, conduct the examination under intracavernosal injection (“into the corpus cavernosum”) of alprostadil (prostaglandin E1, PGE1) (= corpus cavernosum injection test; see under erectile dysfunction).
- Goniometer (measuring instrument for determining angles): determination of the extent of penile curvature (measurement should be made before and after therapy).
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic clarification.
- Cavernosography (contrast examination of the corpus cavernosum of the penis) including cavernosometry (corpus cavernosum function measurement)Indication: after corpus cavernosum injection of 20 µg Prostatglandin E1 (intracorporeal prostate injection) after 30-60 minutes no sufficient erection![Probable cause of erectile dysfunction: increased blood outflow (so-called venous leakage or cavernous insufficiency, synonym: veno-occlusive dysfunction) → Cavernosography]
