{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T23:11:21Z","timestamp":1793056281798,"version":"4.5.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T00:00:00Z","timestamp":1745539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Erectile dysfunction (ED) is a clinically relevant condition, particularly among older men, with vascular causes such as venous leakage and arterial insufficiency being primary contributors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>This study aimed to assess the diagnostic accuracy of a novel, non-invasive approach employing ultrasound-guided venous compression to identify the primary vascular etiology in patients with ED.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A proof-of-concept study was conducted involving 40 male patients with confirmed ED. High-resolution Dynamic Duplex Sonography (DSU) was performed following intracavernosal injection of alprostadil to assess penile blood flow dynamics, including peak systolic velocity (PSV) and end-diastolic velocity (EDV). In 17 patients, a compression ring was individually selected using ultrasound and applied to restrict venous outflow while maintaining arterial inflow. PSV and EDV values were compared between standard DSU and venous compression + DSU (VC-DSU) with an individual selected compression ring. In addition, diagnostic accuracy was validated against CT-arteriography and CT-cavernosography in 10 patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcomes Measures<\/jats:title>\n                  <jats:p>The primary outcome was an improvement in diagnostic accuracy of VC-DSU compared to standard DSU.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>VC-DSU significantly improved detection of the primary vascular cause in ED, with an accuracy of 90% versus 20% for DSU. Under venous compression, changes in PSV served as key diagnostic markers: a marked increase indicated a venous origin, while stable or varied PSV values distinguished arterial or mixed causes. The accuracy of VC-DSU was comparable to CT cavernosography (P\u2009=\u20090.096), highlighting its potential as a reliable non-invasive alternative.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>VC-DSU offers a non-invasive method to assess vascular contributions to erectile dysfunction with promising diagnostic potential to more accurately identify the vascular cause.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths and Limitations<\/jats:title>\n                  <jats:p>Key strengths of this study include its innovative, non-invasive approach and its direct comparison to cavernosography. However, the limited sample size restricts the generalizability of findings, highlighting the need for larger-scale trials to validate these results. Additionally, patient allocation to VC-DSU and cavernosography was based on willingness to participate rather than a predefined protocol, introducing a potential selection bias.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>VC-DSU represents a promising non-invasive and accurate tool that complements traditional diagnostic methods for vascular ED, particularly by enhancing the differentiation of the predominant vascular etiology.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jsxmed\/qdaf073","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T23:50:35Z","timestamp":1745538635000},"page":"1024-1034","source":"Crossref","is-referenced-by-count":3,"title":["Evaluating the feasibility of a new non-invasive technique for improved diagnostics in vascular erectile dysfunction using an ultra-high-resolution ultrasound probe and venous compression: a proof of concept study"],"prefix":"10.1093","volume":"22","author":[{"given":"Andreas","family":"Gutwein","sequence":"first","affiliation":[{"name":"Department of Angiology, Kantonsspital Aarau , Aarau 5001 ,","place":["Switzerland"]},{"name":"Vascular Center of Central Switzerland , Aarau 5001 ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander J","family":"Braun","sequence":"additional","affiliation":[{"name":"Department of Angiology, Kantonsspital Aarau , Aarau 5001 ,","place":["Switzerland"]},{"name":"Division of Clinical and Interventional Angiology, Inselspital (University Hospital of Bern) , Bern 3010 ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Thalhammer","sequence":"additional","affiliation":[{"name":"Department of Angiology, Kantonsspital Aarau , Aarau 5001 ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vignes","family":"Mohan","sequence":"additional","affiliation":[{"name":"Vascular Center of Central Switzerland , Aarau 5001 ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Bovo","sequence":"additional","affiliation":[{"name":"Department of Urology, Kantonsspital Aarau , Aarau 5001 ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong H","family":"Keo","sequence":"additional","affiliation":[{"name":"Division of Clinical and Interventional Angiology, Inselspital (University Hospital of Bern) , Bern 3010 ,","place":["Switzerland"]},{"name":"Division of Angiology, University of Basel , Basel 4051 ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Diehm","sequence":"additional","affiliation":[{"name":"Vascular Center of Central Switzerland , Aarau 5001 ,","place":["Switzerland"]},{"name":"Division of Clinical and Interventional Angiology, Inselspital (University Hospital of Bern) , Bern 3010 ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,4,25]]},"reference":[{"issue":"3","key":"2025082523472817200_ref1","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1016\/j.juro.2018.05.004","article-title":"Erectile dysfunction: AUA guideline","volume":"200","author":"Burnett","year":"2018","journal-title":"J Urol"},{"issue":"1_Part_2","key":"2025082523472817200_ref2","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1111\/j.1743-6109.2009.01624.x","article-title":"Anatomy, physiology, and pathophysiology of erectile dysfunction","volume":"7","author":"Gratzke","year":"2010","journal-title":"J Sex 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