F. Montorsi et al., VASCULAR ABNORMALITIES IN PEYRONIES-DISEASE - THE ROLE OF COLOR DOPPLER SONOGRAPHY, The Journal of urology, 151(2), 1994, pp. 373-375
We attempted to clarify the role of color Doppler sonography in assess
ing the vascular function of untreated Peyronie's disease. A total of
50 patients with a mean 20-month history of penile curvature underwent
color Doppler sonography with the penis in the flaccid state and afte
r intracavernous injection of 20 mu g. prostaglandin El. Of the patien
ts 41 (82%) complained of various degrees of erectile dysfunction, whi
le 9 (18%) reported sustained rigid erections. Pathological peak systo
lic flow velocities (less than 30 cm. per second) of the cavernous art
eries were found bilaterally in 10 patients (20%) and unilaterally in
10 (20%). Peak systolic flow velocity correlated positively with caver
nous artery flow volume and with acceleration. Cavernous artery end di
astolic velocity and resistance index, measured 15 and 30 minutes afte
r vasoactive injection and genital manipulation, were indicative of co
rporeal veno-occlusive dysfunction (greater than 10 and less than 0.75
cm. per second, respectively) in 32 patients (65%). Of these patients
, 11 (22%) had mixed arteriovenous dysfunction and 9 (18%) had normal
cavernous artery flow velocities. Flow along the cavernous arteries is
sometimes altered in cases of Peyronie's disease while corporeal veno
-occlusive dysfunction seems to be the main hemodynamic abnormality. C
olor Doppler sonography should be considered as the initial step in th
e diagnostic evaluation of patients with Peyronie's disease who may be
eligible for surgical treatment.