Background: Vasculogenic erectile dysfunction (ED) may be considered a clinical manifestation of a generalized arterial disease. We attempted to evaluate the association between penile vascular dysfunction and extent of generalized arterial disease proposing a score that incorporates intima-media thickness (IMT) from the carotid and femoral arteries.

Methods: 56 consecutive non diabetic patients (mean age: 58±12 yrs) affected by non-psychogenic and non-hormonal ED were evaluated for penile vascular disease severity by penile Doppler ultrasound. The mean systolic velocity (PSV) shows the greatest flow velocity detectable in an artery throughout the systole. Ultrasonographic assessments of IMT, lumen diameter and plaques in the carotid and femoral arteries were evaluated and a score was developed.

Results: Patients with high score (n=26) compared with subjects with low score were older (59 vs 54 yrs, P=0.06), had decreased mean PSV (25.3 vs 33.1 cm/s, figure) and longer duration of ED (3.8 vs 2 yrs, P<0.05), whereas these two groups did not differ regarding systolic pressure, metabolic profile and smoking status. Analysis of covariance revealed that PSV values of penile arteries were significantly different between the two groups after adjustment for confounders (P<0.05). Moreover, in the entire population, mean PSV exhibited a negative correlation with femoral (r=−0.34, P<0.05) and carotid IMT (r=−0.29, P<0.05).

Conclusions: Ultrasound findings of penile vasculature and duration of ED correlate significantly with increasing severity of carotid and femoral artery wall thickness and atherosclerotic lesions. These data suggest a close interrelationship between progression of vasculogenic ED and early atherosclerosis.