Penile vascular evaluation of men with Peyronie's disease

A penile vascular evaluation was performed upon 95 consecutive men with Peyronie's disease (19 potent and 76 impotent) and 100 consecutive impotent men without Peyronie's disease to gain further understanding of the pathophysiology of erectile dysfunction in patients with Peyronie's disease. Only 1 of the 19 potent patients with Peyronie's disease had abnormal arterial blood flow by duplex ultrasonography and none had evidence of veno-occlusive dysfunction by either duplex ultrasonography or dynamic infusion cavernosometry/cavernosography. In contrast, 36% of the impotent men with Peyronie's disease had abnormal arterial blood flow and 59% had evidence of veno-occlusive dysfunction. There was no significant difference in historical risk factors for impotence between the impotent patients with Peyronie's disease and the control population of impotent patients. However, the presence of veno-occlusive dysfunction in the control population (16%) was significantly less than that of the impotent Peyronie's disease patients (p < 0.001). Although patients with Peyronie's disease may suffer impotence due to arterial occlusive disease, our results indicate that the principal cause of impotence in this patient population is veno-occlusive dysfunction.