Modern methods of instrumental diagnostics of vasculogenic erectile dysfunction

Erectile dysfunction (ED) is a constant or temporary inability to achieve or maintain erection sufficient enough to perform sexual intercourse. The problem of diagnostics and treatment of ED has not only medical but also social importance. The risk of the development of ED increases with age due to serious associated diseases; in particular, due to arterial hypertension, heart diseases and diabetes mellitus. Most causes of ED are considered to be organic, which are subdivided into neurogenic, hormonal, vasculogenic, iatrogenic and mixed. The paper presents data evidence supporting the necessity of application of instrumental methods in the diagnostics of ED and elucidating the exact causes for this condition. Today penile Doppler ultrasound is considered to be “the gold standard” of diagnosis for ED. Russian and foreign authors suggest using penile Doppler ultrasound examination as a screening method due to its low invasiveness, no radiationexposure, optimal efficiency and wide availability. Cavernosography is mostly used in cases which are too complex for the diagnostics, enabling to distinguish arterial insufficiency from venous occlusion. Computer tomography is applied to patients who have suspected venogenic ED in complex clinical cases and when functional cavernosography is not effective enough. This method helps reveal the particular properties of drainage of cavernous bodies, perform topical diagnosis and elucidate the location of venous leakage. Penile magnetic resonance imaging is referred to expensive and technically complicated methods of X-ray diagnostics which have a highly significant role in the visualization of a vascular component of venogenic ED. Radioisotopic methods of diagnostics are now employed in treatment of vasculogenic ED; in most cases penile scintigraphy with 99mTc labeled red blood cells (Tc-RBC) is used. Today in the era of high-tech medicine implementation of new low-invasive, objective, highly informative and harmful methods of diagnistics of ED, is relevant.