Feasability of a Novel Audio-Video Sexual Stimulation System: An Adjunct to the Use of Penile Duplex Doppler Ultrasonography for the Investigation of Erectile Dysfunction

Penile color Doppler ultrasonography (CDUS) with pharmacotesting has become an important tool for evaluating vascular erectile dysfunction (ED), and audio-visual sexual stimulation (AVSS) has been suggested to be helpful in assisting the performance of CDUS during the examination. To investigate the feasibility of using a novel, remotely controllable AVSS system to assist CDUS. This prospective randomized cross-over study recruited 60 consecutive ED patients. Each patient received three randomized sessions of CDUS under different conditions—AVSS, intracavernous injection (ICI) of alprostadil 20 microgram, or AVSS plus ICI. Clinical responses (rigidity) and penile vascular parameters including peak systolic velocity (PSV), end diastolic velocity (EDV), and resistive index (RI) were measured. At the end of the study, patients were asked about how they perceived the AVSS system in generating sexual arousal. PSV, EDV, RI, and rigidity. Fifty-eight ED patients (aged 21–79) underwent 174 sessions of CDUS. The mean PSV and maximal rigidity of patients under ICI alone were significantly greater than those of patients under AVSS alone (48.25±22.78 vs. 36.54±23.25cm/second and 65.00±23.93% vs. 43.28±31.79%, respectively; both P