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Abstract Erectile dysfunction (ED) is defined as a persistent inability (lasting for at least 6 months) to attain and maintain an erection sufficient to permit satisfactory sexual performance . ED represents a common problem with a combined prevalence of 52% of minimal, moderate and complete ED found in 40–70 year old men . The etiology of erectile dysfunction is wide ranging and penile vascular disorders are considered to be an important factor in organic malfunction. Almost 30% of ED is due to the presence of systemic diseases that affect the blood supply of the penis . ED coincides with organic diseases such as diabetes, hypertension, atherosclerosis and ischemic heart disease. The intracavernosal injection test with prostaglandin E1 alone offers limited information on the vascular status. In accordance with the increasing demand for less invasive procedures, penile color-coded duplex sonography (CCDS) combined with the pharmaco-erection test represents a first-line noninvasive approach to investigate arterial and veno-occlusive function. Peak systolic velocity and a change in cavernous artery diameter are indicators of arterial inflow, while the pathological end diastolic velocity and resistance index point out venoocclusive dysfunction. The combined investigation of power and standard color Doppler ultrasound may yield more details of penile vascular anatomy. |