409 Evaluation of the Prevalence and Grading of Calcified Plaques Among Men with Peyronie's Disease: A Prospective Analysis

Peyronie’s disease is the result of abnormal tissues healing in the tunica albuginea. Current therapies for Peyronie’s disease are either surgical or medical. The only FDA proved medical therapy is intralesional injection of collagenase clostridium histolyticum (CCH). Emerging data suggests that calcified plaques have inadequate response to CCH, however this is not listed as a contraindication to CCH. AUA guidelines recognize a benefit to the use of ultrasound in evaluation but do not comment on need for identifying and reporting plaque calcification. To prospectively evaluate the presence of plaque calcification and report the type and grade of among men with Peyronie’s disease who underwent penile duplex ultrasound prior to treatment. We prospectively collected ultrasonographic characteristics of men with Peyronie’s disease starting November, 2018. Plaques were evaluated in the flaccid state and curvature was measured after the injection of intracavernosal Trimix. We utilized a previously described system of plaque type and calcification grading. Briefly, plaque type is as follows: type 1: the plaque appears as a thickening of the tunica albuginea without acoustic shadowing, type 2: a moderately calcified plaque with a typical ultrasound shadow, type 3: a severely calcified plaque slight acoustic shadowing, and grade of calcification is: grade 1 (<0.3 cm), grade 2 (>0.3 cm, <1.5 cm), grade 3 (>1.5 cm; or ≥ 2 plaques >1.0 cm). We additionally collected patient age, degree of penile curvature, peak systolic and end diastolic velocities. Results are presented as means ± standard deviation.