Penile Sonographic and Clinical Characteristics in Men with Peyronie’s Disease

Smith, James F.; Brant, William O.; Fradet, Vincent; Shindel, A.W.; Vittinghoff, Eric; Chi, Thomas; Huang, Yuancheng; Davis, Cole; Conti, Simon; Lue, Tom F.

doi:10.1111/j.1743-6109.2009.01438.x

Cited by 31 publications

(28 citation statements)

References 36 publications

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“…In addition to a comprehensive clinical history, physical examination, and appropriate laboratory investigations, color Doppler ultrasonography of the penis has become valuable in the evaluation of erectile dysfunction. It is a relatively inexpensive and minimally invasive tool that allows a good view of the penile anatomy [678], as well as the flow patterns in the vessels, in the diagnosis of erectile dysfunction [9]. This study was conducted with the aim of determining the frequency of organic and psychogenic causes of erectile dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Causes of Erectile Dysfunction in Patients Undergoing Penile Doppler Ultrasonography in Pakistan

Khanzada

Khan

Hussain

et al. 2017

World J Mens Health

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PurposeIn patients with erectile dysfunction, it is important to differentiate psychogenic from organic causes. Penile Doppler ultrasonography is a relatively inexpensive and minimally invasive tool for this purpose. This study was conducted to evaluate the causes of erectile dysfunction in an adult male population, using penile Doppler ultrasonography.Materials and MethodsA retrospective study was conducted in a single center. All patients who presented with complaints of erectile dysfunction and underwent penile Doppler ultrasonography between July 2014 and June 2016 were included in this study. All examinations were performed using GE Voluson S6 and GE Logiq P5 devices. Following baseline scans, an intracavernosal injection of 20 µg of prostaglandin E1 was given. Peak systolic and end diastolic velocities were measured in each cavernosal artery. Patients with a peak systolic velocity of <25 cm/s were considered to have arterial insufficiency, while an end diastolic velocity of >5 cm/s was considered to indicate venous incompetence.ResultsOut of 97 patients (mean age, 37.09±11.59 years; range, 19~69 years), 50 patients (51.5%) had normal findings, 24 patients (24.7%) had arterial insufficiency, 15 patients (15.5%) had a venous leak, and 8 patients (8.2%) patients had arterial insufficiency with a venous leak. Psychogenic erectile dysfunction was significantly higher among patients aged ≤40 years, while arterial insufficiency with or without a venous leak was significantly higher among patients aged >40 years (p=0.022).ConclusionsA majority of the studied individuals demonstrated no organic cause of erectile dysfunction, thus confirming a high prevalence of the psychogenic etiology, particularly in relatively young individuals.

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Section: Introductionmentioning

confidence: 99%

Evaluation of the Causes of Erectile Dysfunction in Patients Undergoing Penile Doppler Ultrasonography in Pakistan

Khanzada

Khan

Hussain

et al. 2017

World J Mens Health

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“…At present, confirmatory testing for a more comprehensive understanding of the aetiology of MSD is optional and controversy exists as to the usefulness and value of, and indications for, these tests [5]. Recently, however, penile colour Doppler ultrasonography (CDU) has emerged as a valuable addition to the evaluation tools for MSD; it is objective, minimally invasive, relative inexpensive and allows detailed study of penile anatomy [5–8]. Penile CDU has been used to localize and measure Peyronie's plaque lesions and cavernosal disease patterns, as well as to assess vascular flow patterns in the diagnosis of ED and priapism.…”

Section: Introductionmentioning

confidence: 99%

Penile Doppler sonographic and clinical characteristics in Peyronie's disease and/or erectile dysfunction: an analysis of 1500 men with male sexual dysfunction

et al. 2012

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Study Type – Therapy (cohort) Level of Evidence 4 What's known on the subject? and What does the study add? Penile colour Doppler ultrasonography (CDU) can be an invaluable investigative tool to characterize penile abnormalities to complement clinical history and physical examination in the evaluation of men with Peyronie's disease (PD) and/or erectile dysfunction (ED). Although CDU findings between men with PD and those with ED were not markedly different, subtle differences were observed. The classic penile CDU findings in men with PD comprise tunical thickening, intracavernosal fibrosis, septal fibrosis and intracavernosal calcification, while, in men with ED, low peak systolic velocity and high end‐diastolic velocity are found on penile haemodynamics. Previously published studies have focused predominantly on either ED or PD exclusively, or examine the risk of progression to ED in the PD population. To our knowledge, this is the largest and most comprehensive analysis of penile CDU and clinical findings in men with PD and/or ED. The large sample size and multivariable analysis allow meaningful interpretation of the results. This study has found some substantial differences in the penile CDU findings of men with PD and/or ED that have not previously been reported. Although the risk factors of ED may be greater than those for PD, there is crossover in age, cardiovascular risk factors, trauma and penile CDU findings in men with PD and/or ED. OBJECTIVE To explore the differences in penile colour Doppler ultrasonography (CDU) findings between men with Peyronie's disease (PD) and those with erectile dysfunction (ED). MATERIALS AND METHODS Patients presenting with PD and/or ED who underwent penile CDU were recruited to the study. Patient demographics, comorbidities, International Index of Erectile Function‐5 scores, previous therapies and physical findings were documented. Penile curvature, presence of tunical thickening, septal fibrosis, intracavernosal fibrosis and calcification, and cavernosal vascular status were recorded. RESULTS A total of 1500 men underwent penile CDU during the 10‐year period. Of these men, 891 men presented with PD and 609 men had ED only. Men with ED had higher rates of diabetes and coronary artery disease (P < 0.05). Isolated tunical thickening was more common in older men and in the PD cohort. The presence of intracavernosal fibrosis correlated strongly with difficulty maintaining erection (P < 0.05). Impaired cavernosal arterial flow was observed in men with decrease penile rigidity and penile pain, while higher end‐diastolic velocities were found in men with difficulty maintaining erection and tunical thickening on penile CDU. CONCLUSIONS Men with PD and ED had many similarities and differences on penile CDU. Penile CDU continues to be an invaluable clinical tool in the management of men with male sexual dysfunction.

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“…5,6 To our knowledge there have been no studies on the prognostic implications of ultrasound findings in PD. A clearer understanding of sonographic predictors of disease progression and/or eventual need for surgical intervention will enhance the usefulness of ultrasound in evaluating PD.…”

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confidence: 99%

Are Sonographic Characteristics Associated With Progression to Surgery in Men With Peyronie's Disease?

et al. 2010

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Purpose Traditionally, diagnosis and treatment plans for Peyronie’s disease have been based on history and physical examination. Penile ultrasound provides rapid, anatomical information to establish disease severity, and to monitor progression and response to medical therapy. We determined the relationship between ultrasound characteristics and progression to surgical intervention in men with Peyronie’s disease. Materials and Methods We conducted a retrospective cohort study of 518 patients with Peyronie’s disease. Patients completed a Peyronie’s disease specific questionnaire detailing medical history, health related behaviors and Peyronie’s disease characteristics, and underwent sonographic evaluation of the penis. Measurements of subtunical calcifications, septal fibrosis, tunical thickening (tunica thickness greater than 2 mm) and intracavernous fibrosis were made. Progression to surgery was determined from the medical record. Results In this cohort (mean patient age 53.8 years, range 20 to 78) 31% of patients had calcifications, 50% had tunical thickening, 20% had septal fibrosis and 15% had intracavernous fibrosis. Overall 25% of the cohort progressed to surgical intervention after an average followup of 1.25 years (range 0 to 7.6). Patients who underwent surgery were more likely to have subtunical calcifications present at the first clinic visit (OR 1.75, 95% CI 1.16–2.62). No other sonographic characteristics were associated with progression to surgery. After adjustment for age, marital status, degree of curvature, additional penile deformity, difficulty with penetration, ability to have intercourse and prior treatment for Peyronie’s disease, calcifications were strongly associated with progression to surgery (OR 2.75, 95% CI 1.25–3.45). Conclusions In a large cohort of patients with Peyronie’s disease the presence of sonographically detected sub-tunical calcifications during the initial office evaluation was independently associated with subsequent surgical intervention.

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Penile Sonographic and Clinical Characteristics in Men with Peyronie’s Disease

Cited by 31 publications

References 36 publications

Evaluation of the Causes of Erectile Dysfunction in Patients Undergoing Penile Doppler Ultrasonography in Pakistan

Evaluation of the Causes of Erectile Dysfunction in Patients Undergoing Penile Doppler Ultrasonography in Pakistan

Penile Doppler sonographic and clinical characteristics in Peyronie's disease and/or erectile dysfunction: an analysis of 1500 men with male sexual dysfunction

Are Sonographic Characteristics Associated With Progression to Surgery in Men With Peyronie's Disease?

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