DYNAMIC ECHOGRAPHY OF THE PENIS IN THE FOLLOW-UP OF IMPOTENT PATIENTSTREATED WITH INTRACAVERNOUS INJECTIONS

Dynamic echography of the penis (DEP) after pharmacological stimulatio n of erection has been designed to evaluate the albugineal wall thickn ess (AWT), the cavernosal appearance in the normal penis and corporeal changes in patients treated with intracavernous injections presenting with haematomata, hyperechoic images, prolonged erection and Peyronie 's disease. DEP was performed in 973 patients who had had an average n umber of 89 (+/- 16) intracavernous injections for 16.7 +/- 11.7 month s. A total of 1424 DEP examinations were performed. Transducer positio ning, erectile condition, clinical recording and computer retrieval me thods were adapted to gather ultrasonography data. The standard averag e AWTs recorded in patients free from Peyronie's disease and who were untreated were 0.11 cm at the septum, 0.17 and 0.15 cm at the-dorsal r oot and the tip of the albuginea respectively, 0.14 cm ventrally and t he diameter of the corpus cavernosum averaged 1.61 cm. Intracavernous therapy brought an increase in AWT of 15.38% to the septum, 11.76% and 10.53% to the dorsal tip and root respectively and 12.5% ventrally. F requent haematomata induced greater increase, while prolonged erection s did not. Patients with untreated Peyronie's disease were found to ha ve greater AWT which decreased after treatment with intracavernosal in jections. Before treatment abnormal penile hyperechoic images were fou nd in 3.18% (intracavernous images) and 3.31% (albugineal nodules) of DEP, and in 7.09% and 7.54% respectively post-treatment.