Objective measurements of the penile angulation are significantly different than self-estimated magnitude among patients with penile curvature

ABSTRACT Introduction: The study was aimed to assess the presence of actual differences between the objective and the perceived magnitude of a curvature between patients affected by Peyronie's disease (PD) and congenital penile curvature (CPC). Materials and Methods: Wee analysed a cohort of 88 consecutive patients seeking medi- cal help for either CPC or PD. All patients were invited to provide a self-made drawing of their penis in erection in order to obtain self-provided description of the deformity. An objective measurement of the deformity was also performed drawing two intersecting lines through the center of the distal and proximal straight section of the penile shaft. Results: Our findings showed significant differences between patient self-estimation and the objective measurements of the penile angulation performed by trained experts, with only 32% of patients correctly assessing their own curvature. Overall, patients tended to overestimate (56%) their degree of curvature, but the results are different in patients with PD than those with CPC. In the 60 men (68%) who did not accurately assess their curvature, PD patients generally overestimated their curvature versus CPC patients (67% vs 16%). On the contrary CPC patients underestimated their curvature compared to PD (42% vs. 4%). Conclusion: In order to improve patients' satisfaction rates, the surgeon needs to take into consideration the patient's perception of the deformity when planning the type of surgical correction.

Sonographic patterns of Peyronie's disease in patients with absence of palpable plaques

ABSTRACT Purpose Non-palpable isolated septal plaques of the penis are likely present in a significant number of patients affected by erectile dysfunction (ED) and penile pain without deformity or curvature. The aim of this study was to evaluate the ultrasound (US) patterns observed in patients investigated for ED or penile pain without curvature. Materials and Methods We reviewed the medical records of 386 patients who underwent an initial colour-Doppler ultrasonography (CDU) of the penis for DE and/or penile pain without curvature. After satisfying inclusion criteria, 41 patients were individualized. All patients had a non-palpable plaque with involvement of the penile septum. Three US patterns were identified: focal hyperecoic thickening of the intercavernosum septum (IS) with acoustic shadow (pattern 1), non-calcified thickening (isoechoic or slightly hyperechoic (pattern 2), and microcalcifications in the IS without associated acoustic shadow (pattern 3). Results Patients' mean age was 51.3±16.7. ED was the predominant disorder in 73.2% of patients, followed by penile pain and length loss in 19.5% and 7.3% of patients, respectively. 32(78.1%) patients showed the pattern 1, 6 (14.6%) pattern 2, and 3 (7.3%) pattern 3. Plaques size varied from 3 to 13 mm. The penile hemodynamic response to CDU reported abnormal findings distally to the septal plaques in 20 patients (<25cm/sec). Median left and right cavernosum artery flows measured a peak systolic velocity of 31cm/sec and 33 cm/sec, respectively. Conclusions We believe that an US study with CDU provides a way to characterize, localize, and deliver treatment choice in patients with Peyronie's Disease.

Enfermedad de Peyroni / Disease Peyroni

La enfermedad de Peyroni es un desorden de la ténica albugínea del pene, caracterizado por la formación de placas fibrosas, provocando una curvatura patología del mismo. Este artículo hace una revisión de las opciones terapéuticas y la importancia de un diagnóstico temprano, y de esta manera realizar un adecuado manejo del paciente.

Laserterapia para el tratamiento de la enfermedad de Peyronie (induración plástica del pene) / Lasertherapy for the treatment of Peronie's disease

Este estudio consistió en la aplicación de laserterapia a pacientes con enfermedad de Peyronie. Se llevó a cabo de marzo de 1992 a septiembre de 1993 en los servicios de Urología y Medicina Física y Rehabilitación del Hospital de Especialidades de C.M.O., Guadalajara, Jal., México, e incluyó en total a 17 pacientes con este trastorno patológico. El tratamiento consistió en dar 20 sesiones con un aparato emisor de láser del tipo de Helio-Neón de mediana potencia a cada paciente. Los resultados se valoraron al término del tratamiento. Los aspectos a evaluar fueron dolor, curvatura, patrón de relación sexual e involución o desaparición de la lesión (placa). En 63.6 por ciento de los pacientes ocurrió paliación del dolor, en 76.5 por ciento estabilidad de la enfermedad y en 52.9 por ciento disminución en el tamaño de la lesión (placa)