Objective Assessments of Peyronie's Disease

Penile deformity is the most obvious manifestation of Peyronie's disease (PD) and key to determining the optimal method of treatment. Other aspects of PD to consider include plaque size, location, and density; amount of calcification; erection quality; disease progression; and penile anatomy. Few standards exist for the objective assessment of these parameters.

To describe current options and new trends in the objective evaluation of PD with a focus on penile curvature and imaging modalities.

A literature review was performed through PubMed from 1990 to 2017 regarding objective parameters in PD, including imaging modalities, measurements of deformity, and serum markers. Non-English-language articles were excluded.

We sought to assess various objective measurements obtained in patients with PD and to evaluate their usefulness in the evaluation, treatment, and counseling of patients with PD.

Measurement of penile curvature is most accurately performed with in-office goniometric angle measurement of a pharmacologically induced erection. However, new methods of assessing penile curvature using 3-dimensional photography and smartphone and tablet applications can aid clinicians in describing and treating PD. Ultrasound and ultrasound adjuncts provide excellent plaque characterization and assessment of penile vasculature, which can be useful for treatment planning and research. Presence of inflammation can be evaluated using magnetic resonance imaging or nuclear scintigraphy.

Current guidelines only recommend obtaining measurements of penile length and penile curvature in the erect state. However, many other options exist for the objective evaluation of PD. These options can have a role in treatment decision making and help standardize results in PD research. Chen JY, Hockenberry MS, Lipshultz LI. Objective Assessments of Peyronie's Disease. Sex Med Rev 2018;6:438-445.