Elastosonographic Changes in Patients with Peyronie's Disease, before and after Treatment with a Compound Based on <i>Ecklonia bicyclis</i>, <i>Tribulus terrestris</i>, and Water-Soluble Chitosan

Abstract

Several diagnostic techniques have been proposed during the time for the diagnostic evaluation of Induratio Penis Plastica (IPP), due to poor sensitivity and specificity of standard B-Mode Ultrasonography. Shear-Wave elastosonography (SWE) is a relative new ultrasound technique, already used for several organs, which allows evaluating the rigidity of the tissues. Furthermore, we used a compound consisting of Ecklonia bicyclis, Tribulus terrestris, and Biovis (water-soluble Chitosan) with antifibrotic and antioxidant properties and analyzed the elastosonographic variations following the assumption of the compound. From March 2016 to April 2017, 40 patients were recruited with a mean age of 62. All patients underwent elastosonographic measurements at the start of treatment. Subsequently each patient took 1 tablet of the compound of Ecklonia bicyclis, Tribulus terrestris, and Biovis (water-soluble Chitosan) for 6 months. All patients underwent elastosonographic investigation at the end of treatment. The elastosonographic measurement prior treatment, showed that the average of the three measurements (proximal, medial and distal), was 37.05 KPa ± 7.76 SD and 38.8 KPa ± 10.11 SD for the left and right cavernous body, respectively. The examination at the end of the six months of treatment, with the compound showed that the average values of fibrosity were 31.07 KPa ± 7.5 SD and 30.86 KPa ± 11.4 SD for the left and right cavernous body respectively, demonstrating a decrease in fibrosity that was statistically significant (P < 0.01). Our data demonstrate that taking the compound for six months reduces the stiffness of the corpora cavernosa.

Ultrasound Elastography as a Diagnostic Tool for Peyronie’s Disease: A State-of-the-Art Review

“…Regarding the clinical use of shear-wave elastography (SWE) in patients with PD, we found five articles in the literature where this method was used. The authors of these articles have indicated that this technique is very useful for identifying non-palpable or nondetectable plaques with simple ultrasound equipment, as well as for monitoring changes in plaque rigidity during and after conservative treatments [ 42 , 43 , 44 , 45 , 46 ].…”

“…The authors carried out a study on 40 patients with Peyronie’s disease using elastosonographic imaging and employing the shear-wave elastography (SWE) technique to assess the tissue stiffness of the cavernous bodies [ 42 ]. The measurements were conducted using the GE Logic S8 ultrasound machine (GE/General Electric, Chicago, IL, USA) equipped with a linear probe and using a 10 MHz frequency.…”

“…Elastography is mainly used for soft tissue pathologies, such as tissues of the liver, breast, prostate, thyroid, pancreas, nerves, tendons, and muscles. More recently, elastography has also been proposed for the study of PD [ 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ]. Commercial elastography equipment was initially introduced in 2003 and has seen significant advancements over the past two decades.…”

Clinical Presentation of Peyronie’s Disease: A Retrospective Study of 564 Cases

“…However, we propose that these data were very different because they were collected in the year 1976 and solely through palpation, without the use of penile ultrasound. Today, thanks to the technical evolution of ultrasound machines and with the help of elastography, it is possible to identify non-palpable penile plaque [ 91 , 92 , 93 , 94 , 95 , 96 , 97 ].…”