Risk of priapism after dynamic penile Doppler ultrasound: Single-centre experience on a large cohort of patients

Objectives: To evaluate the risk of priapism in patients undergoing Dynamic—Penile duplex ultrasound (D-PDU) who were referred to our Unit between January 2022 and December 2023. Patients and methods: We enrolled 292 patients, of whom 268 underwent Dynamic—Penile duplex ultrasound for erectile dysfunction and 24 for Peyronie's disease. The mean age of the patients was 56 ± 12 years, the mean alprostadil dose administered was 9.17 ± 5.59 mcg and the mean erection response was 79.55 ± 19.95%. To evaluate the occurrence of priapism, we considered i) patients who called our phone number within the first hours following the exam; ii) patients who were referred to our Emergency Department within the 24 h following Dynamic—Penile duplex ultrasound; iii) patients who reported to us the occurrence of priapism at subsequent follow-up visit; iv) patients who e-mailed us to report this side effect. Results: We found no cases of priapism (0/292 patients, 0%). Therefore, statistical analysis with correlation and regression analysis was not conducted. Conclusions: In our opinion, the risk of priapism following Dynamic—Penile duplex ultrasound with alprostadil injection might be re-evaluated, as it appears to be a rare and preventable condition.