Penile bulb imaging

Erectile Function Durability Following Permanent Prostate Brachytherapy

“…From this group of patients, 125 patients were alive in 2008; 124 (99%) completed an IIEF survey in February 2008 and are included in this report. The clinical, treatment, and dosimetric parameters evaluated for this study were age at implant; prostate volume; Contouring of penile bulb and proximal crura was performed on axial CT imaging at 0.5-cm intervals, using previously reported methodology (5,10,11). Briefly, the penile bulb was identified on Day 0 postimplant CT scan as the soft tissue structure bounded by the paired crura laterally, the corpora spongiosum anteriorly, and the levator ani posteriorly.…”

“…Briefly, the penile bulb was identified on Day 0 postimplant CT scan as the soft tissue structure bounded by the paired crura laterally, the corpora spongiosum anteriorly, and the levator ani posteriorly. Using this methodology results in penile bulb volumes typically in the range of 6-10 cm 3 (11). The proximal crura was defined as the proximal most 1.0-cm segment of the crura.…”

Localization of neurovascular bundles on pelvic CT and evaluation of radiation dose to structures putatively involved in erectile dysfunction after prostate brachytherapy

“…These structures were identified on posttreatment CT at 0.5-cm intervals by a single investigator (J.H.N.). The bulb was identified using the methods described by Wallner et al (6). The crura are easily identified on CT.…”

Brachytherapy-associated erectile dysfunction

“…Between the two crura, the corpus spongiosum enlarges to form the penile bulb, which is attached superiorly to the inferior surface of the urogenital diaphragm. Detailed reports illustrating the image-based anatomy of the proximal penis have been published [30]. The penile bulb is best visualized on T2-weighted magnetic resonance imaging (MRI) and appears as an oval-shaped hyperdense midline structure located on average approximately 10 to 15 mm inferior to the apex of the prostate gland.…”

“…After permanent prostate brachytherapy, Merrick et al [14••,35] and Wallner et al [30] reported that treatmentinduced ED was highly dependent on the radiation dose to the proximal penis. Using day 0 CT-based dosimetry, maximal potency preservation was dependent on limiting the penile bulb D50 to less than or equal to 30% of the prescribed dose and the proximal crura D50 to less than or equal to 50% of the prescribed dose [14••].…”