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The natural history of Peyronie's disease: an ultrasonography-based study.
- Source :
-
European urology [Eur Urol] 2008 Mar; Vol. 53 (3), pp. 644-50. Date of Electronic Publication: 2007 Jul 17. - Publication Year :
- 2008
-
Abstract
- Objectives: To define ultrasonographic patterns reflecting different states of Peyronie's disease (PD) and to use them to evaluate the natural history of the disease.<br />Material and Methods: Diagnosis of PD was based on medical and sexual history, physical examination, intracavernosal injection test, and penile ultrasonography. Patients with penile fracture history were excluded from the study. Three groups were formed according to ultrasonographic patterns: solitary hyperechoic lesion without acoustic shadow (group A), moderately hyperechoic multiple scattered calcified lesions with acoustic shadows (group B), dense calcified hyperechoic plaque with acoustic shadow (group C). All patients entered a watchful waiting protocol for 1 yr followed by a new penile ultrasonography.<br />Results: Ninety-five 95 patients with PD were included in the study (mean age, 57.2+/-9.1 yr; mean duration of disease, 12.9+/-8.9 mo). Risk factors associated with cardiovascular disease were present in 79 of 95 patients (83.16%). Eleven (11.6%), 35 (36.8%), and 49 (51.6%) patients were classified into groups A, B and C, respectively. At the end of the study, in group A, reduction of fibrotic lesions and curvature angle was noticed in 9 of 11 (81.8%) patients, whereas plaque formation was noticed in 2 of 11 (18.2%) patients. In group B, plaque and curvature reduction was noticed in 15 of 35 (42.9%) and 12 of 35 (34.3%) respectively, whereas in the rest a dense calcified plaque was noticed. In group C, no ultrasonographic evidence of improvement was noticed; curvature angle was reduced in 4 of 49 (8.2%), owing to the extension of the plaque circumferentially. Significant hemodynamic changes were noticed at the two time points tested (30.53% diagnosed with vascular disease at baseline vs. 46.32% at the end of the study, p=0.03).<br />Conclusions: Corporal ultrasonography in patients with PD allows objective evaluation and classification of disease. The density of echogenic areas and presence of acoustic shadows are predictors of disease stability.
- Subjects :
- Adult
Aged
Blood Flow Velocity physiology
Diagnosis, Differential
Disease Progression
Follow-Up Studies
Humans
Male
Middle Aged
Penile Erection physiology
Penile Induration physiopathology
Prognosis
Prospective Studies
Risk Factors
Severity of Illness Index
Penile Induration diagnostic imaging
Penile Induration etiology
Ultrasonography, Doppler, Color methods
Subjects
Details
- Language :
- English
- ISSN :
- 0302-2838
- Volume :
- 53
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- European urology
- Publication Type :
- Academic Journal
- Accession number :
- 17673362
- Full Text :
- https://doi.org/10.1016/j.eururo.2007.07.013