VASCULAR ABNORMALITIES IN PEYRONIES-DISEASE - THE ROLE OF COLOR DOPPLER SONOGRAPHY

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.