High-resolution real-time ultrasound in Peyronie's disease.

Abstract

Sonography is not considered to be a radiation hazard; it is noninvasive and can be widely used for examining external genitalia. We examined six cases of Peyronie's disease of the penis by high-resolution real-time ultrasound. The sonographic findings include a thick echogenic plaque with echogenicity similar to or higher than the tunica albuginea; a calcified plaque in thickened tunica albuginea; and are occasionally associated with calcification in the corpora cavernosa. Sonography may clearly localize the abnormal thickened area of collagen deposition and calcification. Repeated sonography after intracavernosal papaverine injection may further confirm the correlation of the plaque and the abnormally curved erectile penis. Doppler ultrasound may be used for further evaluation of the vascular condition if impotence coexists.

New Sonographic Aspects of Peyronie Disease

“…In addition, sonography is sensitive enough to identify subtle lesions that are not calcified. 14 Because PD can present with lesions that stabilize quickly or even regress (either partially or completely), 9 sonography appears to represent an ideal method for follow-up of these patients. 14 In addition, sonography can also distinguish lesions that lie outside the echogenic tunica albuginea (Figure 21), which appears to be a new use of this technology in evaluation of the disease.…”

“…It also provides information about the number of plaques, their dimensions, and the exact topography of the lesions in the penis. 3,8,12,[13][14][15] This method can also be used to follow patients who have undergone clinical or surgical treatment and can verify regression of the plaques. 16 Calcified plaques are strongly echogenic and show pronounced posterior acoustic shadowing.…”

Peyronie's Disease Plaque Calcification—Prevalence, Time to Identification, and Development of a New Grading Classification

“…A cohort of these men (N = 834) underwent PDU conducted by a single urologist documenting the presence or absence of calcification in the Peyronie's lesion (Figure ). Areas of calcification were defined as hyperechoic regions with the presence of acoustic shadowing [14]. Each patient underwent physical examination and completed a nonvalidated, but published, PD specific questionnaire detailing medical, social and sexual history, family history of any fibrotic disease, treatment history for PD, and subjective analysis of erectile function, disease progression, and psychological status [12].…”

“…To date, several studies have aimed to describe the Peyronie's patient with plaque calcification [8–10,13,14] The incidence of calcification is currently estimated at 20% to 25%, although it has been reported as high as 88% in one series [8,11] Most of these articles assert that plaque calcification is indicative of “mature,” “advanced,” “severe,” or “chronic” disease [9,10,15] Current clinical opinion holds that patients with calcified Peyronie's plaques are less responsive to nonsurgical therapies [5,8,10,16,17]. Most of the published literature focusing on ultrasound evidence of plaque calcification is observational.…”

The Relationship between Diabetes mellitus, Impotence and Veno-Occlusive Dysfunction in Peyronie’s Disease Patients

“…Induratio penis plastica, as it was originally termed, is a localized connective tissue disorder resulting in fibrotic plaque formation in the tunica albuginea of the corpora cavernosa [1][2][3]. Generally it is with a 0-99° dorsal, lateral or ventral curvature of the erect penis often with pain on erection which may make sexual intercourse difficult or impossible [4].…”