Efficacy of virtual glasses in audio-visual sexual stimulation during penile color duplex Doppler ultrasonography.

Abstract

To examine whether audio-visual sexual stimulation (AVSS) with virtual glasses is effective in improving the recording of penile hemodynamics during penile color duplex Doppler ultrasonography. A total of 64 consecutive patients with erectile dysfunction underwent penile color duplex Doppler ultrasonography after intracavernosal injection of 10-20 microg prostaglandin El and subsequent genital stimulation. AVSS with virtual glasses and earphones was applied when peak systolic velocities (PSV) were less than 35 cm/s or end diastolic velocities (EDV) were more than 5 cm/s. PSV, EDV and the resistive index of both cavernosal arteries were continuously monitored. Clinical erectile response was assessed with visual inspection and manual palpation. AVSS with virtual glasses was performed on 40 of 64 patients. AVSS improved the clinical erectile response in 26 (65%) of 40 patients. Doppler ultrasonography without AVSS identified 11 (27.5%), 5 (12.5%), and 24 (60%) patients with arteriogenic, veno-occlusive, and mixed-type impotence, respectively. However, after real-time AVSS 15 (37.5%), 7 (17.5%), 8 (20%), and 10 (25%) patients demonstrated non-vasculogenic, arteriogenic, veno-occlusive, and mixed-type impotence, respectively. Real-time AVSS improved the Doppler wave forms in 65% of cases. AVSS with virtual glasses improves the recording of physiologic erectile response and may be used as a valuable tool during penile color duplex Doppler ultrasonography.