The Arterial Deficit: Characterizing Erectile Dysfunction with Penile Colour Doppler in a Ugandan Population.

To evaluate the diagnostic utility of penile colour Doppler ultrasonography (CDU) in characterizing the vascular etiology of erectile dysfunction (ED) in a Ugandan population. A retrospective analysis was conducted on 51 patients with non-neurological, non-metabolic ED at a tertiary institution. All patients underwent standardized penile CDU after intracavernosal injection of 20 µg Prostaglandin E1 (PGE1), with assessment of peak systolic velocity (PSV), end-diastolic velocity (EDV), and cavernosal artery diameter. The mean age was 48.65 years. Arterial insufficiency was the most common finding (45.1% of cases), with 78.26% of these being bilateral. Mixed arterial-venous dysfunction was identified in 35.29% of patients, while isolated venous leakage was rare (3.92%). Only 13.73% of studies were normal. A key finding was the disparity between structural and functional assessments: while B-mode ultrasound appeared normal in 74.51% of cases, Doppler revealed vascular abnormalities in the vast majority. Penile CDU is a valuable non-invasive tool for detecting vasculogenic ED in this setting, with arterial insufficiency being the predominant etiology. The frequent discrepancy between normal B-mode anatomy and abnormal hemodynamics highlights the essential role of doppler velocimetry in diagnosis.