Imaging in Peyronie’s Disease

Diagnosis of PD is based on medical and sexual history, physical examination and mostly imaging. US is the primary imaging modality of choice due to its easy availability, low risk and ability to image and quantify both calcified and soft tissue elements of PD. A Colour Doppler Penile Ultrasound study is necessary to evaluate vascular status of penile arteries for better surgical choice. Mammography technique and CT are able to detect calcifications of Peyronie’s plaques and to determine the degree of plaque calcification. Non-calcified plaques, however, cannot be shown accurately. MRI is at least as sensitive as ultrasonography to determine the extent of plaque formation and to assess whether the corpora cavernosa and the penile septum are involved. Nevertheless, MRI is an expensive imaging modality and is not commonly used in our clinical practice to evaluate patients with PD. Penile sonoelastography can be a valuable diagnostic tool but needs further clinical studies.