Ultrasound findings of ruptured Peyronie’s plaque: Case report and review of the literature

Abstract

We present here a rare case of rupture of tunica albuginea and corpus cavernosum, in the site of a Peyronie's plaque, which happened in a 61-year-old man during a vacuum cleaner masturbation. Ultrasound study showed an irregular hyperechoic defect at the cavernosal rupture site in correspondence of the Peyronie's plaque. The hematoma was evacuated, partially plaque excised, and the tear repaired. Ultrasonography is an ideal technique for evaluating patients with penile trauma and can be routinely used in an emergency. It is a non-invasive method that gives faster results than cavernosography and Magnetic Resonance Imaging.KEY WORDS: Peyronie's disease; Penile trauma; Plaque; Ultrasound; Masturbation. high-frequency (7-12.0 MHz) linear transducer. The exact location of the tear has been demonstrated as an interruption of the thin echogenic line of the tunica albuginea and showed an association of hematoma outside dorsal side of the corpora cavernosa (Figure 1). Color-Doppler ultrasound revealed some vascularity at the periphery of the lesion, however the corpus spongiosum was intact, and vascular structures appeared to have a normal flow. After the informed consent process, the patient was subjected to surgery. The hematoma was evacuated, partially plaque excised, and the tear repaired with prolene 3/0. In the setting of a dorsal curvature, a short full-thickness vertical incision was made on the ventral shaft tunic opposite the area of maximum curvature, which was then closed transversely to shorten the ventral aspect and correct the curvature. An artificial erection created with intracavernosal injection of normal saline showed an intact repair with no leakages and angulations. The wound was closed with 3/0 vicryl. Duration of hospital stay was 2 days after surgery. After 10 weeks, the patient was able to be sexually active as before. Follow-up with patient occurred every 3 months for 15 months, and did not show any significant angulations of penis.

Buccal mucosa graft in surgical management of Peyronie’s disease: Ultrasound features and clinical outcomes

“…The evaluation period was 72 months. Data regarding pre-operative work-up, including IIEF (IIEF-5) questionnaire administration, detailed clinical history and penile dynamic ultrasound (PGE1-induced erection) features were collected (5,6). The surgical procedures were done previous penile degloving and using a relaxing incision (double Y or H shaped) at the point of maximum curvature on the penis.…”