Dynamic Penile color-Doppler ultrasonography (CDS) is to be considered a second-level invasive test for the etiological diagnosis of erectile dysfunction. Some scientific evidences underline the possibility of replacing the drug-injection with a PDE-5 Inhibitors.

The purpose of the study was to evaluate the possible relationship between the basal and dynamic results of penile Doppler ultrasound, complications and patientʼs compliance, after intra-cavernosal injection (ICI) or after vardenafil administration and audio visual sexual stimulation (AVSS).

Between January an May 2007, 40 ED patients, median age 52 years (range 45-58), without contra-indications for using PDE-5 inhibitors, were included in the study.

Each patient underwent two CDS in basal and dynamic condition using ICI (PGE 10 MCG), or, after 2 weeks, using vardenafil 20 mg and AVSS. The same operator, blinded performed all the tests.

A satisfaction questionnaire was administrated to the patients after each study session. The differences were considered statistically significant for values of P < .05

After CDS and ICI there were 30 patients (75%) with nonvasculogenic ED, 2 patients (5%) with arteriogenic ED, 8 patients (20%) with venogenic ED.

All the diagnosis were confirmed after 2 weeks with CDS and vardenafil, except in 4 patients (2 with arteriogenic and 2 with venogenic ED) vardenafil non-responders.

Most part of patients (35/40) would prefer, in the need of procedure repetition, vardenafil instead of ICI.

The results of this study demonstrate that the two techniques are comparable in terms of diagnostic results. Patients’preferences highlight the conclusion that vardenafil can be regarded as an alternative to FIC during CDS evaluation.