We thank Aversa and colleagues for their comments on our Brief Report (Int J Impot Res (2002) 14, 201–203). Although Aversa et al state that they have ‘A different point of view’ we do not really think so. In our paper, we have shown that in many ED patients color Doppler sonography (CDS) revealed a so-called vascular abnormality, while these patients appeared to be physiologically speaking ‘sexually potent’, that is, penile erections sufficient for coitus. One wonders: what is in such cases the relevance of the CDS diagnosis? In most instances, the ED treatment will not be directed by this ‘finding’.
Our main conclusion was ‘that CDS as a (first) screening test in ED-patients is of limited value’. In Discussion, we further indicate where we believe CDS screening is of diagnostic value: in ‘… ED-patients who repeatedly fail to respond to high doses of oral phosphodiesterase inhibitors or intracavernous injected vasoactive substances’. This is not so much different from the final conclusion reached by Aversa et al ‘…CDS remains a useful…..diagnostic screening in those ED-patients who have a significant risk of cardiovascular disease or a prior failure to conventional therapies.’
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