Erectile dysfunction in peyronie's disease: prevalence and etiology as demonstrated by color duplex doppler ultrasound

You have accessJournal of UrologyCME1 Apr 2023PD26-11 ERECTILE DYSFUNCTION IN PEYRONIE’S DISEASE: PREVALENCE AND ETIOLOGY AS DEMONSTRATED BY COLOR DUPLEX DOPPLER ULTRASOUND Laura Geldmaker, Daniela Haehn, Sarah Hampton, Christopher Walker, Colleen Ball, and Gregory Broderick Laura GeldmakerLaura Geldmaker More articles by this author , Daniela HaehnDaniela Haehn More articles by this author , Sarah HamptonSarah Hampton More articles by this author , Christopher WalkerChristopher Walker More articles by this author , Colleen BallColleen Ball More articles by this author , and Gregory BroderickGregory Broderick More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003304.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Peyronie’s Disease (PD) can coexist with erectile dysfunction (ED). International guidelines recommend that PD management includes an assessment of each patient’s ability to initiate and sustain erection, by intracavernosal injection (ICI) test with or without duplex Doppler ultrasound. Distress caused by PD may limit a patient’s ability to assess adequacy of penile rigidity. Our objective was to assess vascular erectile integrity non-invasively in the setting of PD. METHODS: Consecutive patients who underwent ICI followed by Color Doppler Duplex Ultrasound (CDDU) at our institution were retrospectively reviewed. CDDU findings were recorded following injection of alprostadil and again after a period of privacy and visual sexual stimulation (VSS). Erectile re-observations were made with patient standing after VSS. Erectile rigidity was assessed by one physician and all patients were asked to compare to their best quality home erection. CDDU findings including peak systolic velocities, end diastolic velocities, and resistive indices were recorded. Among patients diagnosed with PD, comparisons of patient characteristics between those with and without a diagnosis of ED were made using a Wilcoxon rank sum test (continuous characteristics) or Fisher’s exact test (categorical characteristics). RESULTS: Our assessment of 1853 men using CDDU found 1239 were diagnosed with PD by CDDU. Among those with PD, 353 (28.5%) were diagnosed with PD only (vascular normal) and 886 (71.5%) were diagnosed with PD+ED. Patients with a CDDU diagnosis of PD only were younger [median: 57 (49, 62) vs. 61 (55, 67) years, p<0.001], less likely to have hypertension [119/349 (34.1%) vs. 424/885 (47.9%), p<0.001], less likely to have used PDE-5 inhibitor [243/348 (69.8%) vs. 692/882 (78.5%), p=0.002], and less likely to have failed to a PDE-5 inhibitor [150/243 (61.7%) vs. 531/691 (76.8%), p<0.001] compared to men with PD+ED. Mean SHIM scores were not normal in either group. SHIM scores were higher among those with PD only [median (interquartile range): 14 (8–20) vs. 10 (6–18), p<0.001]. CDDU diagnoses for men with PD+ED were AI 284/886 (32.1%), CVOD 371/886 (41.9%), mixed vascular ED 231/886 (26.1%). CONCLUSIONS: In our practice more than 90% of men undergo history and physical examination with same day CDDU for the evaluation of PD. In this series, Doppler analysis found that 71.5% of PD patients have some form of vascular ED. We recommend an evidence-based assessment of vascular erectile integrity before any patient is triaged to medical or surgical intervention. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e739 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Laura Geldmaker More articles by this author Daniela Haehn More articles by this author Sarah Hampton More articles by this author Christopher Walker More articles by this author Colleen Ball More articles by this author Gregory Broderick More articles by this author Expand All Advertisement PDF downloadLoading ...