Penile Shear Wave Elastography Can Demonstrate and Classify the Development of Erectile Dysfunction in Patients with Type 1 Diabetes Mellitus: A Prospective Observational Study.

INTRODUCTION

This study aimed to evaluate the utility of penile shear wave elastography (PSWE) in demonstrating erectile dysfunction (ED) in patients with type 1 diabetes mellitus (DM) and to determine an optimal cut-off value.

METHODS

Patients aged 18-40 who were diagnosed with type 1 DM were included. Erectile function was assessed using the five-item International Index of Erectile Function (IIEF-5). Arterial, venous, and non-vascular etiologies of ED were classified based on peak systolic velocity and end-diastolic velocity data obtained from the penile corpus cavernosum via penile Doppler ultrasonography. Five separate PSWE measurements were performed for each patient, and the final kilopascal (kPa) value was calculated as the mean of these five measurements. Patients with IEFF-5 scores ≥17 (no or mild ED) were assigned to Group A, while those with scores <17 (moderate and severe ED) were assigned to Group B.

RESULTS

Among the 132 patients enrolled in the study, 81 had no or mild ED (Group A) and 51 had moderate and severe ED (Group B). PSWE measurements were significantly lower in Group A (p < 0.001). The overall cut-off value for cavernous corporal pressure (CCP) was determined to be 15 kPa. When categorized by the underlying pathology, the cut-off values were 16 kPa for ED due to arterial insufficiency, 13 kPa for venous insufficiency, and 11 kPa for non-vascular causes.

CONCLUSION

This study categorizes the vascular etiologies of ED with type 1 DM and identifies specific PSWE cut-off values for each category. Implementing closer follow-up protocols for patients exceeding these thresholds may positively impact the treatment of ED patients. However, further research is warranted to validate these findings.