Penile sonographic and clinical characteristics in men with peyronie's disease

James F. Smith, William O. Brant, Vincent Fradet, Alan W. Shindel, Eric Vittinghoff, Thomas Chi, Yun Ching Huang, Cole B. Davis, Simon Conti, Tom F. Lue

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Introduction: 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). Aims: 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. Main Outcome Measures: 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). Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)2858-2867
Number of pages10
JournalJournal of Sexual Medicine
Volume6
Issue number10
DOIs
StatePublished - 2009

Keywords

  • Calcification
  • Intracavernosal fibrosis
  • Peyronie's disease
  • Septal fibrosis
  • Tunical thickening
  • Ultrasound

ASJC Scopus subject areas

  • Urology
  • Obstetrics and Gynecology
  • Reproductive Medicine
  • Medicine(all)

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    Smith, J. F., Brant, W. O., Fradet, V., Shindel, A. W., Vittinghoff, E., Chi, T., Huang, Y. C., Davis, C. B., Conti, S., & Lue, T. F. (2009). Penile sonographic and clinical characteristics in men with peyronie's disease. Journal of Sexual Medicine, 6(10), 2858-2867. https://doi.org/10.1111/j.1743-6109.2009.01438.x