Color Doppler ultrasound assessment of penile vascular system in men with Peyronie's disease

Kadıoğlu, Ateş; Tefekli̇, Ahmet; Erol, Hasan Fehmi; Çayan, Selahíttín; Kandıralı, Engin

doi:10.1038/sj.ijir.3900569

Cited by 71 publications

(43 citation statements)

References 22 publications

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“…In the early stage of the disease, inflammation predominates and lasts for 12-18 months, causing erectile discomfort and unstable curvature [23]. In this early phase, hyperperfusion can be demonstrated around the plaques by power Doppler [23]. A more chronic phase follows with stable deformity and plaque size.…”

Section: Further Ultrasound Findingsmentioning

confidence: 99%

“…At ultrasound, it is manifested by hyperechoic thickened plaques of the tunica albuginea, which may be calcified ( Figure 11) [22]. In the early stage of the disease, inflammation predominates and lasts for 12-18 months, causing erectile discomfort and unstable curvature [23]. In this early phase, hyperperfusion can be demonstrated around the plaques by power Doppler [23].…”

Section: Further Ultrasound Findingsmentioning

confidence: 99%

“…Up to 80% of patients with Peyronie's will suffer from ED [24,25], although the association is multifactorial, with pain and psychological factors also recognised. In addition, many authors have postulated that ED in Peyronie's is secondary to vascular abnormalities [24,[26][27][28], with both arterial incompetence and venous leakage documented [23].…”

Section: Further Ultrasound Findingsmentioning

confidence: 99%

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Investigation of erectile dysfunction

Patel¹,

Halls²,

Patel³

2012

The British Journal of Radiology

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ABSTRACT. Erectile dysfunction (ED) represents a common and debilitating condition with a wide range of organic and non-organic causes. Physical aetiologies can be divided into disorders affecting arterial inflow, the venous occlusion mechanism or the penile structure itself. Various imaging modalities can be utilised to investigate the physical causes of ED, but penile Doppler sonography (PDS) is the most informative technique, indicated in those patients with ED who do not respond to oral pharmacological agents (e.g. phosphodiesterase type 5 inhibitors). This review will examine the anatomical and physiological basis of penile erection, the method for performing PDS and features of specific causes of ED, and will also consider the alternative imaging modalities available. Erectile dysfunction (ED) represents a substantial burden upon public health. Studies have estimated that approximately 50% of the male population aged between 40 and 70 years will suffer from ED at some stage, with 10% of these affected severely [1]. On average, a general practitioner is estimated to see between one and five new cases of ED per month [2], and the impact upon the psychosocial health of the sufferer and his relationships may be considerable. ED is defined as the persistent inability to achieve or maintain penile erections of sufficient value to engage in satisfactory sexual activity [3]. Impotence tends not to be used as a descriptive terminology currently as it is felt to imply failure.Many physical causes of ED exist, with only 10-20% of sufferers believed to have a solely psychological cause [2]. There are many organic causes for ED, with the majority of these based upon vascular insufficiency. These organic causes are summarised in Table 1.Imaging in the investigation of ED is dominated by penile Doppler sonography and the main focus of this article will examine this technique. Alternative modalities such as MRI and angiography will also be explored, and the penile anatomy and the physiology of erection will be outlined. Penile anatomyThe central erectile structures are bilateral corpora cavernosa, seen as dorsolaterally placed low-reflectivity bodies on ultrasound, surrounded by the thick fibrous tunica albuginea (Figures 1 and 2). The corpora cavernosa are formed by multiple sinusoids composed of endothelium and smooth muscle. These sinusoids are capable of substantial volume expansion. The solitary ventrally located corpus spongiosum is enclosed by a thinner layer of tunica albuginea and surrounds the penile urethra. The spongiosum is anatomically independent of the cavernosa.The three corpora are enclosed by the more superficial Buck's fascia.The penile arterial supply displays slight variation in its anatomy [4,5]. The penis is usually supplied by branches of the internal pudendal artery, which continue as the penile artery. The bulbar artery supplies the proximal shaft and is the first branch of the penile artery, which then divides into the dorsal and cavernosal arteries (Figure 3). The cavernosal artery enters and ...

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Section: Further Ultrasound Findingsmentioning

confidence: 99%

Section: Further Ultrasound Findingsmentioning

confidence: 99%

Section: Further Ultrasound Findingsmentioning

confidence: 99%

See 1 more Smart Citation

Investigation of erectile dysfunction

Patel¹,

Halls²,

Patel³

2012

The British Journal of Radiology

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“…In our series, PSV value of >25 cm=sec was accepted as normal. When we made a comparison of color doppler ultrasonographic findings in different series of impotent Peyronie's disease patients; normal penile vascular system, venoocclusive dysfunction, arterial disease and mixed penile vascular diseases were found as 23%, 47%, 29% and non-stated, respectively, in Lopez and Jarow series; 18%, 40%, 20%, and 22% in Montorsi et al series; 43%, 4%, 48% and 4% in Levin and Coogan series; 27%, 29%, 41% and 2% in Brock et al series; and 23%, 31%, 6% and 38% in Kadioglu et al series [1,[8][9][10][11]. These rates in our patients were 61%, 35%, 0% and 3% in normopotent Peyronie's disease patients with dorsal curvature, and 59%, 36%, 0% and 4% in normopotent ventral curvature patients with no statistical difference between lateral ventral curvature groups.…”

Section: Discussionmentioning

confidence: 99%

“…Although VOD has been claimed to be present in a high percent of Peyronie's patients with erectile dysfunction, the role of arterial disease has also been investigated. Different series with color doppler ultrasonography some accepting peak systolic velocity (PSV) of more than 35 cm=sec as normal, some 25 cm=sec as normal, different series with color doppler reported a deterioration in cavernous arterial inflow in 29% to 52% of the patients with Peyronie's disease [2,[8][9][10][11]. In a study by Levine and Coogan [9], normal penile color doppler ultrasound parameters for cavernous arterial flow was considered to be PSV values >35 cm=sec as in the other study by Chiou et al [2] reporting the same findings.…”

Section: Discussionmentioning

confidence: 99%

Does the Type of the Peyronie's Curvature Effect Penile Vascular Parameters in Normopotent Men?

Metin

Kayıgίl²,

Atmaca³

et al. 2005

Archives of Andrology

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& The aim of this study is to assess whether the type of penile curvature in normopotent men with Peyronie's disease affects the penil vascular doppler ultrasound parameters. Fifty-three normopotent patients within the stabilization phase of Peyronie's disease were evaluated retrospectively by means of color doppler ultrasonography. Bilateral cavernosal artery diameters before and after intracavernous papaverine injections, peak systolic and end diastolic velocities and the amount of leakage in the deep dorsal penile vein were compared in dorsal and ventral curvature groups of Peyronie's disease. 61% of the patients in dorsal and 59% in ventral Peyronie's curvature group have normal ultrasonographic penile vascular system. 35% and 3.3% in dorsal curvature group and 36.4% and 4.5% in ventral curvature group have venoocclusive dysfunction and mixed vascular pathologies, respectively, having no statistical correlation between them (p > 0.05). No arterial pathology was observed in any group. There was no correlation between the type of Peyronie's curvature and the penile doppler ultrasonographic findings in normopotent patients.

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