The relationship between the type of penile abnormality and penile vascular status in patients with peyronie's disease.
OBJECTIVE
We evaluated penile vascular status using penile duplex Doppler ultrasound (PDDU) according to the type of abnormality in men with Peyronie's disease (PD).


METHODS
A total of 523 patients with PD were evaluated retrospectively. Each patient underwent PDDU following injections of 10 to 15 mug prostaglandin E1 intracavernously with accompanying visual sexual stimulation to evaluate penile blood flow. Abnormalities were divided into 7 groups. Objective evaluation of penile curvature was done with a protractor during maximum erection. Specific criteria were used to categorize patients into varying definitions of vascular status. The results were compared statistically among groups.


RESULTS
Mean patient age +/- SEM was 54.2 +/- 1.5 years. The most frequently noted type of curvature was dorsal (43.5% of cases), followed by lateral (24.8%). Mean peak systolic velocity in the ventrolateral group was the highest, while the lowest peak systolic velocity was noted in the hourglass abnormality group. The hourglass group had the highest rate of pure arterial insufficiency, while veno-occlusive dysfunction was seen most commonly in the ventral curvature group. The ventrolateral group showed the most normal vascular status parameters.


CONCLUSIONS
This study demonstrates there is a relationship between the type of curvature and penile hemodynamics. Although patients with PD in the hourglass abnormality group were the youngest, this abnormality was associated with the poorest penile vascular status. Patients with ventrolateral curvature had the best penile hemodynamics in our series. PDDU findings may direct the treating physician to different treatment options.
Kendirci
Muammer
M
Department of Urology, Tulane University Health Sciences Center, New Orleans, Louisiana 70112, USA.
Nowfar
Sepehr
S
Gur
Serap
S
Jabren
George W
GW
Sikka
Suresh C
SC
Hellstrom
Wayne J G
WJ
D003920:Diabetes Mellitus / Q000453:epidemiology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010411:Penile Induration / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D010413:Penis / Q000002:abnormalities* / Q000098:blood supply*; D012039:Regional Blood Flow; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014463:Ultrasonography