Cavernosometry: methodology and reproducibility with and without pharmacological agents in the evaluation of venous impotence.

Venous impotence can be evaluated by cavernosometry, although this is a controversial issue. We have evaluated various techniques for cavernosometry: with and without intracavernous papaverine, with different dosages and modalities, with different modes of induction flow and at various intracavernous pressures. A standardised technique was tested and retested in 32 impotent men. If pharmacocavernosometry is accepted as the most reliable test and a maintenance flow less than 20 ml/min indicates optimal venous occlusion, plain cavernosometry gave 6% false positive and 16% false negative results. Pharmacocavernosometry was found to be highly reproducible with regard to maintenance flow for patients thought to have optimal venous occlusion and for those with supposed leakage. The induction flow was of no diagnostic value. After injection of papaverine the maintenance flow became a reproducible parameter for quantifying venous outflow and could be measured with an intracavernous pressure equivalent to systolic blood pressure to minimise cavernous arterial inflow and increase reproducibility.