Penile sonographic and clinical characteristics in men with Peyronie's disease.
BACKGROUND
Ultrasonography of the penis is readily available to the urologist and gives good anatomic detail of soft tissue structures. It has not been widely utilized in the assessment of Peyronie's disease (PD).


OBJECTIVE
To describe the sonographic characteristics of the penis in PD and the relationship between clinical and sonographic features.


METHODS
This cross-sectional study enrolled patients from a single clinical practice. A PD-specific questionnaire was administered and sonographic evaluations were performed.


METHODS
Sonographic characteristics of men with PD.


RESULTS
Tunical thickening, calcifications, septal fibrosis, and intracavernosal fibrosis, were observed at initial clinical evaluation in 50%, 31%, 20%, and 15% of men, respectively. Men aged 40-49 (OR 2.4, P = 0.02) and men aged 50-59 (OR 2.4, P = 0.004) were more likely to have sub-tunical calcifications relative to men under age 40. Men with septal fibrosis had fewer chronic medical conditions such as diabetes (OR 0.3, P = 0.04), hypertension (OR 0.5, P = 0.03), and coronary artery disease (OR 0.2, P = 0.05), and presented within 1 year of disease onset (OR 2.1, P = 0.001). Men with septal fibrosis were less likely to have lost penile length (OR 0.5, P = 0.04) and more likely to be able to have intercourse (OR 1.9, P = 0.05). Men with intracavernosal fibrosis were less likely to have penile pain (OR 0.5, P = 0.05), but more likely to have penetration difficulty during intercourse (OR 1.9, P = 0.008), an additional penile deformity (OR 1.8, P = 0.02), or rapid onset of disease (OR 1.7, P = 0.04). Tunical thickening was associated with a decreased ability to have intercourse (OR 2.3, P < 0.001).


CONCLUSIONS
PD is a clinically and sonographically heterogeneous condition. Sonography is a safe, low-cost, and rapid means of objectively characterizing lesions in this condition. This may help track the evolution of the condition in individual patients and in the future may be useful for tailoring treatment strategies.
Smith
James F
JF
University of California-Department of Urology, 1600 Divisadero, box 1695, San Francisco, CA 94143, USA. smithjf@urology.ucsf.edu
Brant
William O
WO
Fradet
Vincent
V
Shindel
Alan W
AW
Vittinghoff
Eric
E
Chi
Thomas
T
Huang
Yun-Ching
YC
Davis
Cole B
CB
Conti
Simon
S
Lue
Tom F
TF
D000328:Adult; D000367:Age Factors; D000368:Aged; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology; D002140:California / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005355:Fibrosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010411:Penile Induration / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D010413:Penis / Q000000981:diagnostic imaging* / Q000473:pathology*; D015995:Prevalence; D011795:Surveys and Questionnaires; D017540:Tunica Media / Q000000981:diagnostic imaging* / Q000473:pathology*; D014463:Ultrasonography