Department of Urology

Penile Ultrasound and Doppler


An imbalance of the penile arterial blood inflow and venous blood outflow, and nerve dysfunctions are the main causes of erectile dysfunction in more than 75% of men. Penile ultrasound and duplex doppler, enables characterization of arterial and venous blood flow with in the erect penis.  It also allows for a detailed survey of the corpora cavernosa to identify calcification or scarring inside the erectile tissue of the penis.


A medicine called prostaglandin E1 or papaverine is injected into the penis with a tiny needle. This medicine induces penile erection in most men when injected directly into the penis causing dilation of the penile arteries and increasing blood flow into the penis within minutes. The doctor will then assess the degree of the erection and use the ultrasound to see whether your arteries are healthy and how much blood is flowing into the penis through each artery. The doctors can also assess the degree of venous outflow from the penis and the function of your erection nerves during the test. If the erection lasts beyond the completion of the test, you may require injection a small amount of adrenalin to prevent a prolonged erection. Do not leave until released by the doctor.

Preoperative Considerations

Do not take Viagra, Cialis, or Levitra the day prior or the day of your procedure, as this may lead to a prolonged and painful erection.

Postoperative Care

Do NOT engage in sexual intercourse or masturbation the day you have the test.

Possible side effects or complications:
• Painful injection – this is a part of the test to see whether the nerve inside the penis is normal. A patient with nerve problems may feel severe aching pain for several hours.
• Small area of bruising (black and blue) or bleeding at the injection site. This happens more often if aspirin or anticoagulant (coumadin or heparin) is taken.
• Feeling lightheaded after injection, which normally disappears within a few minutes. This occasionally happens in patients with nerve problems or too much overflow from the penis.

Prolonged (rigid) erection lasting more than 4 hours – IMMEDIATELY call the Urology Clinic at 206-598-4294, or if after business hours, go directly to the emergency room – do not wait till the next day.