title: Penile sonographic and clinical characteristics in men with Peyronie's disease.
abstract: 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.
authors.affiliation: University of California-Department of Urology, 1600 Divisadero, box 1695, San Francisco, CA 94143, USA. smithjf@urology.ucsf.edu
authors.forename: James F
authors.initials: JF
authors.lastname: Smith
authors.forename: William O
authors.initials: WO
authors.lastname: Brant
authors.forename: Vincent
authors.initials: V
authors.lastname: Fradet
authors.forename: Alan W
authors.initials: AW
authors.lastname: Shindel
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.forename: Thomas
authors.initials: T
authors.lastname: Chi
authors.forename: Yun-Ching
authors.initials: YC
authors.lastname: Huang
authors.forename: Cole B
authors.initials: CB
authors.lastname: Davis
authors.forename: Simon
authors.initials: S
authors.lastname: Conti
authors.forename: Tom F
authors.initials: TF
authors.lastname: Lue
mesh_terms: 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