The role of imaging in the diagnosis and management of Peyronie's disease

Abstract

Purpose of review Several imaging modalities exist for the assessment of Peyronie's disease. However, comprehensive recommendations for using these objective modalities based on large-scale evidence-based studies do not yet exist. Our objective is to evaluate current imaging techniques and provide a model that we follow in our clinic in the workup and management of Peyronie's disease. Recent findings Computed tomography and radiography excellently visualize penile plaque calcifications, and MRI adeptly identifies plaques in complex locations, such as the corporal septum. Ultrasonography has extensive applications in plaque localization and characterization. Used along with color Doppler ultrasound, it is capable of detecting vascular abnormalities. Sonoelastography is an emerging subtype of ultrasongraphy that utilizes elastic properties of tissue to identify penile plaques that may not be visualized with other modalities. Summary Ultrasonography is the preferred imaging modality in Peyronie's disease and noninvasively characterizes penile plaques and monitors plaque response to various treatments. At our center, we perform ultrasonography with intracavernosal injection in all patients with Peyronie's disease to evaluate the degree of curvature, plaque characteristics, and concomitant erectile dysfunction to better guide management decisions.

Use of penile shear wave elastosonography for the diagnosis of Peyronie’s Disease: a prospective case–control study

“…PD is an insidious condition that has been underdiagnosed and underestimated by both patients and physicians for many years. Various diagnostic techniques have been used to diagnose PD [ 18 ].…”

“…PD is an insidious condition that has been underdiagnosed and underestimated by both patients and physicians for many years. Various diagnostic techniques have been used to diagnose PD [18]. Some radiological methods, such as radiography and computed tomography, have the ability to correctly visualize calcified plaques, but they are unable to properly investigate tissues without calcified plaques [19].…”

Full Regression of Peyronie’s Disease Plaque Following Combined Antioxidant Treatment: A Three-Case Report

“…With respect to diagnostic imaging, although sonographic assessment of the penis has been reported in the literature to be unable to provide adequate plaque measurements, we believe, instead, that accurate plaque size can be obtained if a highly sensitive, state-of-the-art ultrasound machine is employed, and, above all, if the evaluation is performed by a physician experienced in the diagnosis of this disease [ 30 , 31 , 32 ]. We, therefore, believe we owe our results not only to the substances used in the course of the therapy, but also to the characteristics of our ultrasound assessment, which enabled us to accurately diagnose the area affected by the disease (plaque) and constantly monitor the evolution of the disease at scheduled follow-ups.…”

Patients with Peyronie’s disease achieve complete plaque regression after multimodal treatment with antioxidants: a case series

“…In the literature, ultrasound imaging of PD has been described by many as being incapable of providing accurate plaque measurements [ 42 ]. On the contrary, we believe that an ultrasound examination performed with a cutting-edge ultrasound machine by a highly experienced operator with extensive knowledge of the disease can provide a measurement of the plaque that is very helpful to assess patients at presentation and to accurately evaluate treatment outcome at follow-up [ 43 , 44 ].…”