Vasculogenic impotence and cavernosal oxygen tension

Aims of this study: To determine the associations, if any, of cavernosal oxygen tension with vasculogenic impotence. Materials and Methods: We evaluated penile cavernosal blood gas levels in men with suspected vasculogenic impotence during penile duplex ultrasonography and/or dynamic infusion cavernosometry and cavernosography (DICC). Patients with suspected impotence were evaluated from 1992 - 1996. Patient ages ranged from 24 - 75 y (mean 48 y). Eighteen men had arteriogenic impotence diagnosed by abnormal penile duplex ultrasound after injection of a vasoactive agent, and 23 men had venous leakage diagnosed by DICC. Results: Eighteen men with arteriogenic impotence had the following mean blood gas values: pH = 7.38 ± 0.01, PCO2 = 45.50 ± 0.94, PO2 = 65.17 ± 2.16. Twenty-three men with venogenic (venous leak) impotence had the following mean cavernosal blood gas values: pH = 7.41 ± 0.01, PCO2 = 42.26 ± 0.83, PO2 = 74.17 ± 2.51. The differences in PO2 were significant (P < 0.05). A subgroup of men with severe venous leakage had PO2 values that were similar to the low arterial PO2 values. Conclusion: The low P02 in patients with arteriogenic impotence, and the subset of men with severe venous leak impotence, support a global concept of low cavernosal PO2 as a mechanism for both arteriogenic and venogenic impotence.