Happy New Year Flownetters!  Congrats to those who have learned of success wrt
RVT exam.  I have some peculiar test results from a penile study that I would
like some feedback on:

After injection of Trimex, cavernosal artery doppler waveform changed from
monophasic with diastolic flow on Rt.; monophasic with no detectable diastolic
flow on Lt. to bilateral biphasic (increased peak velocity) with sustained
retrograde flow throughout diastole.  The artery wall was brightly echogenic
bilaterally.  Post injection penile PVR was strongly enhanced from preinjection
shape. Full elongation with moderate rigidity was achieved by approx. 15 min.
(normal for the patient). 
Application of a pressure cuff for post injection PBI caused immediate increase
in rigidity with increased cuff pressure.  When pressure was released, rigidity
immediately returned to previous post injection state.  PBI increased from 0.67
to 0.77.

B-mode imaging shows shadowing cast by the Tunica albuginea in regions (this
may represent the injection sites).
Cavernosal artery diameter increased by 50% bilaterally.
The patient is 34 years old.

Any suggestions?
I think inflow is normal.
Could this represent disease of the distal arteriolar bed?
Could there be a proximal AV fistula?  

Steve Knight
Fletcher Allen Health Care
(University of Vermont)