Imaging modalities and clinical assesment in men affected with Peyronie’s disease

BACKGROUND: Peyronie’s disease (PD) is characterized by the formation of fibrous tissue plaques within the tunica albuginea, usually causing a penile deformity and a subsequent erectile dysfunction. Diagnosis of PD is based on medical and sexual history, physical examination and imaging examinations, i.e.: ultrasound, color Doppler ultrasound, magnetic resonance and X-ray mammography. MATERIAL/METHODS: Ultrasound appears superior to all other methods for depicting calcifications, with the detection rate of 100%. It is safe, non-invasive, repeatable and reliable. It should be a method of choice in most standard cases of Peyronie’s disease. With color Doppler ultrasound (CDU), one can find hyperperfusion around the plaques as a sign of inflammation in the active state of the disease. CDU is useful in diagnosing erectile dysfunction which is observed in most cases of PD. RESULTS: MR is superior to US and X-ray as regards the detection of periplaque inflammation, though this information can be obtained from medical history and penile plaque palpation. MR, being an expensive imaging modality, should be reserved for special cases, i.e.: plaques located at the penile basis, a suspicion of malignant disease, and prior penile surgery. CONCLUSIONS: X-ray mammography is the most accurate in showing calcifications as well as the angle of penile curvature. However, the possibility of obtaining this information does not justify the use of ionizing radiation for that purpose.