A Critical Analysis of Methodology Pitfalls in Duplex Doppler Ultrasound in the Evaluation of Patients With Erectile Dysfunction: Technical and Interpretation Deficiencies - Beyond the Abstract

This paper was part of an initiative from the Journal of Sexual Medicine to explore the methodological aspects of sexual medicine studies. It was motivated by the perception of protocol heterogeneity in the literature regarding the conduct of Penile Duplex Doppler ultrasound (PDDU). As a result, the interpretation and validity of the results is difficult.


Of major concern, we found that approximately three-fourths of studies did not mention the use of an intracavernosal agent redosing schedule; more than half did not mention any form of rigidity assessment. These factors limit data interpretation and raised significant concern regarding the possibility of a high rate of false, adrenaline mediated, abnormal PDDU.

Finally, we propose a list of recommendations to guide authors when performing future studies using and reporting PDDU parameters in their protocols.

Written by: Bruno Nascimento, Eduardo P Miranda, Jean-Etienne Terrier, Felipe Carneiro, John P Mulhall

Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Sexual Medicine Group, Division of Urology, Hospital das Clinicas - University of Sao Paulo Medical School, Sao Paulo, Brazil., Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Division of Urology, Federal University of Ceara, Ceara, Brazil., Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Urology, Hôpital privé Jean Mermoz Lyon, France., Department of Radiology, Hospital das Clinicas - University of Sao Paulo Medical School, Sao Paulo, Brazil., Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

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