(628) Evaluation of Erection Hardness Score with Penile Doppler Ultrasound in Brazilian Patients with Erectile Dysfunction

Introduction Erectile dysfunction (ED) is a prevalent condition affecting men worldwide, with implications for quality of life. Assessment of erectile function is essential to guide diagnosis and treatment strategies. Among the available diagnostic tools, penile Doppler ultrasound with pharmacological stimulation stands out as a reliable method for evaluating penile vascular dynamics and structural integrity. This technique allows for the direct measurement of peak systolic velocity in the cavernous arteries, providing information on arterial flow and possible vascular insufficiencies. Objective To investigate the association between Erection Hardness Score (EHS) levels and peak systolic velocities (PSV) in the cavernous arteries. Methods This was a cross-sectional study involving penile hemodynamic assessment using pharmacologically induced penile Doppler ultrasonography in men with erectile dysfunction who sought care at a private andrology center in Brazil between 2024 and 2025. Peak systolic velocities of the right and left cavernous arteries were measured, and erectile rigidity was classified according to the Erection Hardness Score, ranging from 0 to 4. Statistical analysis included descriptive measures, Spearman’s correlation test, and Youden’s Index to determine optimal cutoff points. Results Data from 1.068 patients were analyzed. In the diagnostic assessment, the optimal cutoff points determined by Youden’s Index were 29.85 cm/s for the left cavernous artery and 29.67 cm/s for the right. The mean peak systolic velocities were 48.98 cm/s in the right cavernous artery and 49.73 cm/s in the left. A progressive increase in mean PSV values was observed in accordance with penile rigidity levels, as shown in Table 1. However, within the group classified as EHS 4, approximately 5% of patients exhibited PSV values below 30 cm/s, this phenomenon occurs when intracavernosal pressure exceeds systolic arterial pressure. Spearman’s correlation analyses revealed moderate positive associations between PSV values and penile rigidity scores. The correlation between left cavernous artery PSV and EHS was ρ = 0.396 (p < 0.001), while the correlation between right cavernous artery PSV and EHS was ρ = 0.3447 (p < 0.001). These findings indicate that higher levels of penile rigidity are significantly associated with increased peak systolic velocities. Conclusions The findings demonstrate a moderate positive association between Erection Hardness Score levels and peak systolic velocity values, supporting the combined use of these measures as complementary tools in diagnostic evaluation. Disclosure No