Compression Rings for Erectile Dysfunction Diagnoses? New Technique Could Improve Accuracy

Erectile dysfunction (ED) occurs when the penis cannot sustain an erection adequate for satisfactory sexual activity. Currently, ED can fall into one or more of three categories.

• Psychogenic origins are related to things like depression, anxiety, and low self-esteem.
• Neurological origins are related to nerve disruptions like those that result from disorders like spinal cord injuries, traumatic brain injuries, multiple sclerosis, or the effects of a post-radical prostatectomy (removes the prostate, and sometimes tissues around it).
• Mechanical origins are related to issues with endothelial function, which has to do with how blood flows in and out of the penis (venous and arterial functions).

Currently there are a few ways to diagnose mechanical causes of ED. Mainly, using ultrasound technologies with induced erections to test for vascular flow and leakages. This method is effective, however may lead to a misdiagnosis in the true cause of ED. Additionally, a technique called cavernosography may be used (although rarely), which involves injecting liquid called contrast into the erect penile veins and scanning with a computed tomography (CT) scan, which is considered an invasive procedure that many may want to avoid.

Introducing: Compression Rings

A Swiss research team recently looked into a new method for diagnosing mechanical erectile dysfunction using vascular compression alongside ultrasound technology. The main goal was to see how accurate and feasible it was to use compression rings to differentiate a venous leakage from arterial insufficiency, when compared to cavernosography and ultrasound-only methods.

• All 40 men included in the study were assessed using the older Dynamic Duplex Sonography (DSU) method, in which an erection is induced, and ultrasound is used to assess for endothelial issues.
• Seventeen (17) of these men volunteered to test the venous compression DSU (VC-DSU) method, in which an erection is induced, and compression rings of various sizes are used in descending order until adequate compression is reached, and the DSU is able to view the isolated venous and arterial blood flows.
• Finally, 10 out of the 17 men volunteered for a cavernosography.

To test accuracy, researchers measured peak systolic velocity (PSV), which, in this case, boils down to blood flowing into the penis. They also measured end-diastolic velocity (EDV), which is the blood flowing out of the penis. In this study, a decrease in PSV would be a sign of insufficient blood flow (arterial insufficiency), and higher EDV would indicate a venous leakage.

The compression ring works to ensure inflow, and restrict outflow, which would decrease EDV, if it were high. So, if both numbers change, researchers will know that it is an issue with both blood flow and leakage.

Is it Effective?

According to the study, VC-DSU was 90% accurate (9/10 patients) and did not differ much when compared to the cavernosographies. This outperformed the accuracy of using just the DSU, which was 20% accurate (2/10 patients), and performed worse than the cavernosographies.

Results show that a reduction of PSV under compression from original measurements may mean arterial insufficiency, so less blood flowing in and reduced blood pressure. Basically, less blood flowing out of the penis (due to compression), plus no change or increase in blood flowing into the penis, equals venous leakage.

Additionally, control over compression adjustment allowed for real-time feedback on how efficient the compression rings were, and it enhanced the capabilities of VC-DSU to diagnose vascular ED. Isolating the PSV by making EDV appear normal allowed the researchers to see if ED was caused by a combination of arterial flow issues and venous leakage. If both EDV and PSV levels are reduced with compression, then this is likely the case.

Conclusion

VC-DSU provided better differentiation between arterial and venous causes of ED, which is a common challenge with older techniques, especially when it comes to diagnosing a combination of the two.

Applying proper venous compression to achieve lower EDV levels appeared to improve accuracy without invasive procedures (like cavernosography) and can reduce the chance of false negatives, which are more common with traditional ultrasounds.

Researchers believe that with more research, VC-DSU may be able to help diagnose mechanical causes of ED more effectively, leading to more appropriate and targeted treatment methods.

References:

Gutwein, A., Braun, A. J., Thalhammer, C., Mohan, V., Bovo, A., Keo, H. H., & Diehm, N. (2025). Evaluating the feasibility of a new non-invasive technique for improved diagnostics in vascular erectile dysfunction using an ultra-high-resolution ultrasound probe and venous compression: A proof of concept study. The Journal of Sexual Medicine, 22(6), 1024–1034. https://doi.org/10.1093/jsxmed/qdaf073