168 Peyronie’s Disease: Can We Standardize Utrasonographic Descriptors?

Abstract

Evaluation of Peyronie’s disease (PyD) utilizing penile Color Doppler Duplex Ultrasound (CDDU) provides insight on disease characteristics, severity of concomitant erectile dysfunction, and anatomical variations in disease presentation. The literature provides limited guidance regarding the ultrasonographic appearance of Peyronie’s plaques. Published guidelines suggest successful triage of PyD patients should be based upon evaluation of both penile deformity and the presence or absence of vascular ED. The purpose of this study is to establish a functional and reproducible anatomical classification system for Peyronie’s disease based on a large retrospective series in which a single examiner utilized penile CDDU to evaluate variations in plaque appearance and ultrasonographic characteristics. During work-up for Peyronie’s disease, 571 patients were examined using penile CDDU performed by a single surgeon at our institution between February 2005 to March 2018. Images and disease characteristics were recorded at the time of CDDU evaluation and Doppler 2D images were reviewed by an independent examiner based on classification criteria as follows: Grade I- hypoechoic shadowing without calcification; Grade II- focal microcalcifications; Grade III- scattered microcalcifications; Grade IV- confluent calcified and palpable plaque (a) of the tunica albuginea or (b) of the septum.