# Towards an Improved Standard in Penile Duplex Doppler Ultrasonography: A Randomized Crossover Trial of 3D Virtual Glasses for Audiovisual Sexual Stimulation

## TL;DR

Using 3D virtual glasses for sexual stimulation during a medical test improves results and reduces anxiety compared to a regular monitor.

## Contribution

This study introduces 3D virtual glasses as a novel method for sexual stimulation in penile Doppler ultrasound testing.

## Key findings

- 3D virtual glasses produced higher hemodynamic parameters like RI and PSV compared to a desktop monitor.
- Patients using 3D glasses were significantly more likely to achieve a functional erection.
- 3D glasses reduced anticipatory anxiety for future procedures.

## Abstract

Background/Objectives: We compared the efficacy of audiovisual sexual stimulation (AVSS) using 3D virtual glasses with a desktop monitor. Methods: In this randomized crossover study, 60 patients with ED underwent two penile duplex Doppler ultrasound sessions 1 week apart, each after intracavernosal prostaglandin E1 injection. Patients were randomly assigned to receive AVSS via 3D virtual glasses or a desktop monitor in the first session, with crossover in the second. We measured the resistive index (RI), erectile hardness score (EHS), peak systolic velocity (PSV), anxiety (State-Trait Anxiety Inventory), and satisfaction (visual analog scale). Results: 3D virtual glasses were associated with superior outcomes. The linear mixed models analysis showed higher adjusted mean RI (p < 0.001), PSV (p < 0.001), and satisfaction (p < 0.001) for 3D glasses. Generalized estimating equations analysis showed patients were 6.68 times more likely to achieve functional erection (EHS ≥ 3) with 3D glasses (odds ratio 6.68, 95% confidence interval [2.54, 17.55], p < 0.001). Anticipatory anxiety before subsequent examinations was lower with virtual glasses (p < 0.001). Conclusions: AVSS with 3D virtual glasses is associated with superior hemodynamic parameters and clinical responses consistent with reduced false-positive diagnoses. It also lowers anticipatory anxiety for subsequent procedures, enhancing patient experience.