Ultrasound Evaluation of Corporovenous Occlusive Dysfunction in Men Post-Radiation Therapy for Prostate Cancer

Radiation therapy (RT) for prostate cancer (PC) is often associated with erectile dysfunction (ED), leading researchers to investigate the rates of corporovenous occlusive dysfunction (CVOD) in affected men. This study included men who received RT, with or without androgen deprivation therapy (ADT), and developed ED with a poor response to phosphodiesterase type 5 inhibitors (PDE5i) and intracavernosal injections (ICI). The researchers performed penile duplex Doppler ultrasound (DUS) to assess the patients, using a vasoactive agent redosing schedule. Arterial insufficiency (AI) was defined as a peak systolic velocity (PSV) below 30 cm/sec, while CVOD was indicated by end diastolic velocity (EDV) values of 5 cm/sec or higher. The study included 156 men with a median age of 69 years, with 54% having undergone ADT for a median of 15 months. The analysis revealed that CVOD was present in 59% of patients, while AI was diagnosed in 14% and a combination of both in 7%. Factors predictive of CVOD included older age, duration of ADT exposure of 12 months or more, and dyslipidemia. The findings suggest that CVOD is a common complication in men who have undergone RT for PC, highlighting the importance of monitoring these patients for vascular issues that may contribute to ED. This study underscores the need for comprehensive evaluations and tailored management strategies for men experiencing post-RT erectile dysfunction, particularly in relation to CVOD.