ORIGINAL ARTICLE Is there a concordance between carotid and penile cavernosal artery intima-media thickness in patients with erectile dysfunction? CS Gokkaya 1 , BK Aktas 1 , U Toprak 2 , S Yahsi 1 , S Bulut 1 , C Ozden 1 and A Memis 1 1 Department of Urology, Numune Education and Research Hospital, Ankara, Turkey and 2 Department of Radiology, Numune Education and Research Hospital, Ankara, Turkey This study aimed to investigate the predictive accuracy of carotid and cavernosal Doppler ultrasound findings for discriminating patients with vasculogenic erectile dysfunction (ED). Fifty patients with complaints of ED were included. B-mode ultrasound of bilateral carotid arteries were performed and peak systolic velocity (PSV), end-diastolic velocity (EDV) and intima-media thickness (IMT) values were measured. Afterwards, corresponding values of cavernosal arteries were obtained by penile color duplex ultrasonography (P-CDU). Of total 50 patients, 29 (58%) were included in vasculogenic ED group and 21 (42%) in non-vasculogenic ED group according to P-CDU findings. There was a significant difference between groups for cavernosal IMT (P ¼ 0.012) but not for carotid IMT (P ¼ 0.601). When patients were reclassified according to carotid IMT values (IMT of the first group o0.9 mm and the second X0.9 mm), carotid PSV and EDV values were different (P ¼ 0.033 and 0.018, respectively). Cavernosal PSV and EDV displayed no difference (P ¼ 0.816 and 0.123) while cavernosal IMT and percent change of cavernosal caliper were significantly different (P ¼ 0.014 and 0.018). Carotid PSV and EDV successfully mirrored respective measurements in cavernosal artery. However, carotid IMT failed to demonstrate such a correlation. Cavernosal IMT seems promising as an additional tool in the evaluation of cavernosal function. International Journal of Impotence Research (2012) 24, 44–48; doi:10.1038/ijir.2011.46; published online 22 September 2011 Keywords: color Doppler ultrasonography; common carotid arteries; ED; vasculogenic impotence Introduction Endothelium has a critical role in cardiovascular biology 1 and endothelial dysfunction has been regarded as a common denominator in the patho- physiology of both cardiovascular disease and erectile dysfunction (ED). 2–4 Cardiovascular disease and ED share numerous risk factors in etiology, such as diabetes, dyslipidemia, hypertension, tobacco use and obesity. All these risk factors contribute to the formation of oxidative stress, the fundamental re- sponsible factor for endothelial dysfunction. 5–7 At the early phase, endothelial dysfunction has been mani- fested with the decrease of endothelium-dependent vasodilatation 8,9 and later on structural vascular abnormalities such as increased intima-media thickness (IMT) and atherosclerotic plaque devel- opment could be detected. 10 As an indicator of the alteration of arterial wall, thickening of carotid artery intima-media layer has been found to be associated with risk factors for atherosclerotic disease. 11,12 Additionally, measurement of carotid IMT by B-mode ultrasound has been accepted as a non-invasive and reproducible reference methodo- logy to evaluate the degree of generalized athero- sclerosis. 13 Carotid IMT values X0.9 mm were considered increased according to the literature. 14 Besides carotid arteries, IMT measurement has been also studied in the lower extremity arteries (femoral and popliteal arteries) 15 and even in such small vessels as cavernosal arteries 16 by the virtue of modern ultrasound technology. Results were pro- mising for IMT as a supplementary tool in the ultrasound evaluation of ED along with conven- tional peak systolic velocity (PSV) and end-diastolic velocity (EDV) measurements. 16 Received 1 March 2011; revised 26 July 2011; accepted 17 August 2011; published online 22 September 2011 Correspondence: Dr BK Aktas, Numune Egitim ve Ara- stirma Hastanesi, Uroloji Klinigi, Ulku Mah. Talatpasa Blv. Nr:5, Ankara 06100, Turkey. E-mail: kaanaktas73@hotmail.com International Journal of Impotence Research (2012) 24, 44–48 & 2012 Macmillan Publishers Limited All rights reserved 0955-9930/12 www.nature.com/ijir