Penile duplex sonography in the diagnosis of venogenic impotence.
 This study tested the hypothesis that measurements of cavernous arterial diastolic velocity and resistance index could provide a quantitative but noninvasive measure of penile corporal venous leakage.
 Seventy-four men were studied with duplex ultrasonography after intracavernosal injection of 60 mg of papaverine.
 Fourteen men had normal erection and served as controls.
 Sixty men had a 1-year history of transient fading or incomplete erections.
 In all subjects the peak systolic velocity and end-diastolic velocity were measured, and the resistance index was calculated (peak systolic velocity--end-diastolic velocity/peak systolic velocity).
 Men with normal erections had peak systolic velocities greater than 35 cm/sec and end-diastolic velocities less than 4.5 cm/sec (group 1).
 Patients with incomplete erections (group II) could be classified into three subgroups.
 Twenty-three patients with end-diastolic velocities greater than 4.5 cm/sec and normal peak systolic velocities greater than 35 cm/sec were suspected to have corporal venous leakage (group A).
 Eighteen patients had normal end-diastolic velocities less than 4.5 cm/sec.
 Twelve of this group had peak systolic velocities less than 35 cm/sec, and six had peak systolic velocities ranging from 37 to 44 cm/sec.
 These patients were suspected of having arterial insufficiency (group B).
 Fifteen patients with end-diastolic velocities greater than 4.5 cm and peak systolic velocities less than 35 cm were suspected of having both venous leakage and arterial insufficiency (group C).
 Twenty-one patients with abnormal diastolic flow underwent infusion pharmacocavernosometry to determine the saline maintenance infusion rate necessary to maintain an intracavernosal pressure of 90 to 100 mm Hg or a full erectile response.
