Ultrasound on Erect Penis Improves Plaque Identification in Patients With Peyronie's Disease.

Yu Liu,Xiaolin Liu,Jinbing Li,Dequan Zheng,Xiaohong Shi,Shengchun Shu

doi:10.3389/fphar.2019.00312

Abstract

ObjectivesTo compare the sensitivity of identification of penile plaques in the erect and flaccid penises by ultrasound in patients with Peyronie’s disease (PD).Materials and MethodsA total of 75 PD patients were screened by palpation and ultrasonography for penile lesions in both flaccid and erect penises induced by prostaglandin E1 (PG-1) injection.ResultsA total of 138 lesions were identified by ultrasound in the erect penises induced by injection of PG-1. However, only 74.6% of the lesions (103) were detectable by the palpation of the flaccid penises, and 84.1% (116) by ultrasound of the flaccid penises. The ultrasound confirmed 99 of the palpated lesions in the flaccid penises. The detection rate of lesions in drug-induced erect penises by ultrasound was significantly higher than those in the flaccid penises by the ultrasound (P < 0.01) or palpation (P < 0.0005) The type of penile lesions identified by ultrasonography included tunical thickening, calcifications, septal fibrosis, and intracavernosal fibrosis. The ratios of these lesions confirmed by ultrasound were 52.6, 33.6, 6.0, and 7.8%, respectively, in the flaccid penises, and 55.8, 28.3, 8.7, and 7.2%, respectively, in the erect penises.ConclusionDrug-induced erection can be used in suspicious PD patients when penile lesion is not identified by palpation or ultrasound in the flaccid penis.

Highlights

Peyronie’s disease (PD) is a common penile disorder with a prevalence between 3.2–8.9% (Schwarzer et al, 2001; Rhoden et al, 2001; Mulhall et al, 2004)
The penile abnormalities found in PD patients included curvature in erect state (26.67%), decreased penile rigidity (38.67%), penis shortening (9.33%), and inability to sustain erection (8.00%)
A total of 138 penis plaques were identified by ultrasound in 75 PD patients after prostaglandin E1 (PG-1) induced erection

Summary

Introduction

Peyronie’s disease (PD) is a common penile disorder with a prevalence between 3.2–8.9% (Schwarzer et al, 2001; Rhoden et al, 2001; Mulhall et al, 2004). PD can cause pain, deformity, shorting, as well as bending of the penis during erection, and results in erectile dysfunction (ED) (Hauck and Weidner, 2001; Ralph et al, 2010). It has been reported that PD is related to the penile plaques formed by aberrant wound healing after minor trauma on the penis (Zargooshi, 2004; Gur et al, 2011). Some PD patients have a genetic predisposition to localized fibrosis formation in response to trauma on the penis (Hauck et al, 2004; Domes et al, 2007). Peyronie’s disease can be initially diagnosed based on patient’s history and palpation of the penis (Weidner et al, 1997; Hauck et al, 2003), and is subsequently confirmed with evidence of lesions by ultrasound.

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