Duplex ultrasound findings in men with Peyronie's disease

Peyronie's disease is a fibrotic process involving the penis, which presents with painful erections, penile chordee, and, less frequently, impotence. Duplex Doppler ultrasound is particularly well suited to the evaluation of these patients, since it can provide information about Peyronie's plaque and the penile vasculature noninvasively. Duplex ultrasound examinations were performed on 30 impotent and three potent men with Peyronie's disease. Presenting symptoms included painful erections in 30% and abnormal curvature in 93%. A plaque was palpable in 31 (94%) of the patients. Ultrasound evaluation revealed evidence of a plaque in only 13 (39%) patients. The majority of these plaques were visualized as hyperechoic areas with or without shadowing. Some isoechoic plaques were identified due to significant thickening of the dorsal tissues. Doppler analysis of cavernosal artery blood flow revealed evidence of arterial disease in eight (27%) of the impotent patients. Although ultrasonography was not as sensitive as palpation in identifying Peyronie's plaques, ultrasonography was better able to determine the depth of fibrosis extension into the corpora.