NE-AUA 2006 Annual Meeting, September 28 - 30, 2006, The Westin Hotel & Rhode Island Convention Center Providence, Rhode Island
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Relationship of Penile Curvature and Penile Vascular Status in Patients with Peyronie's Disease
Andrew S. Nisbet, MD, Stanton C. Honig, MD.
University of Connecticut, Hartford, CT,

Introduction and Objectives: Peyronie’s disease results in penile deformity of varying degrees and configuration. It is also associated with erectile dysfunction. Kendirci et al reported their experience with duplex ultrasound findings in patients with different penile deformities. The purpose of this study was to evaluate Peyronie’s patients regarding degree and direction of curvature, and duplex Doppler ultrasound (DDU) findings.
Methods: Charts of 92 patients with Peyronie’s disease were reviewed. 73 patients had data with history, physical examination, erectile dysfunction status and DDU findings. All patients underwent DDU with intracavernosal injection of either PGE1, or a trimix of PGE1, papaverine and phentolamine. Pertinent information regarding vascular risk factors, erectile dysfunction, degree of curvature, direction of curvature was collected. Type of curvature was divided into 4 categories; dorsal, ventral, lateral and other (hourglass, s-shape, etc). DDU findings were categorized as either cavernosal artery insufficiency (CAI) with end systolic velocity <30cm/sec or veno-occlusive dysfunction (CVOD) with end diastolic velocity >3cm/sec. Correlation among erectile status, curvature of penis and penile hemodynamics was performed.
Results: The average patient age was 54 years and the average age at development of disease was 49 years with no difference among the groups. 53% had dorsal curvature (DC), 22% had ventral curvature (VC), 22% had lateral curvature (LC) and 3% had miscellaneous types of penile deformities (MC). DC and MC deformities had the highest rate of CAI at 54% and 60% respectively, while LC and VC rates were 29% and 33% respectively. LC and DC rates of CVOD were highest at 23% and 20% respectively. Rates of erectile dysfunction (ED) were highest among those with MC (100%) and DC (48%) and lower in LC (35%) and VC (16%). Most men in all four groups were able to achieve penetration: DC 59%, MC 60%, VC 75%, and LC 65%. 22% of patients had a history of trauma. 62% of patients had ED risk factors such as CAD, smoking, hypercholesterolemia, HTN, diabetes, or XRT.
Conclusions: Peyronie’s disease presents with differing degrees and directions of curvature. There was no correlation among the type of penile deformity, degree of curvature, and the incidence of CAI or CVOD, although patients with MC did have a higher incidence of ED. More studies are necessary to determine whether specific patterns of injury and curvature result in or are correlated with specific penile hemodynamic abnormalities.


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