COLOR DOPPLER AND DUPLEX ULTRASOUND ASSESSMENT OF PEYRONIES DISEASE IN IMPOTENT MEN

280 patients (aged 28 to 74 years, mean 57) with erectile failure (EF) underwent colour Doppler and duplex ultrasound imaging (CDI) followin g intracorporeal papaverine. After achieving a full, or nearly full, e rection visual inspection and palpation revealed plaques and/or constr iction or deformity of the penis in 55 (20%) cases. 10 (4%) were known to have Peyronie's plaques prior to referral. Of these 55 patients ul trasound showed focal echogenic plaques in 14 (25%) and diffuse thicke ning of the tunica albuginea in 41 (75%). CDI diagnosed arteriogenic E F in 20 (36%) of these patients, venous leak in 10 (18%), arterial and venous in two (4%) and a normal response in 23 (42%). In 11 (20%) pat ients (seven with arteriogenic EF and four with venous leak) the plaqu e was seen to be affecting vessels. These results indicate that abnorm alities of the tunica albuginea are far more common in patients presen ting with erectile failure than previously thought. We believe that th e diffuse thickening is a form of Peyronie's which is only recognized after pharmacological induction of penile erection.