Materiały źródłowe

• #1 Peyronie’s disease: Diagnosis and medical management – UpToDate

  https://www.uptodate.com/contents/peyronies-disease-diagnosis-and-medical-management

  Peyronie’s disease (PD) is an acquired, localized fibrotic disorder of the tunica albuginea, resulting in penile deformity; mass; pain; and, in some men, erectile dysfunction. […] Diagnosis is generally straightforward, based on history and physical examination. Ultrasound can also be used to better define the fibrotic plaque and identify calcifications. […] In most cases, medical management should be initiated once the diagnosis of PD is made. […] The diagnosis and medical management of PD will be reviewed here.

• #2 Peyronie’s Disease Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/peyronies-disease-guideline

  1. The purpose of this guideline is to provide a clinical framework for the diagnosis and treatment of Peyronie’s disease (PD). […] 2. Clinicians should engage in a diagnostic process to document the signs and symptoms that characterize Peyronie’s disease. The minimum requirements for this examination are a careful history (to assess penile deformity, interference with intercourse, penile pain, and/or distress) and a physical exam of the genitalia (to assess for palpable abnormalities of the penis). (Clinical Principle) […] 3. Clinicians should perform an in-office intracavernosal injection (ICI) test with or without duplex Doppler ultrasound prior to invasive intervention. (Expert Opinion) […] 4. Clinicians should evaluate and treat a man with Peyronie’s disease only when he/she has the experience and diagnostic tools to appropriately evaluate, counsel, and treat the condition. (Expert Opinion)

• #3 Peyronie’s disease – Wikipedia

  https://en.wikipedia.org/wiki/Peyronie%27s_disease

  Peyronie’s disease diagnosis is mostly clinical. Patient history and physical examination are crucial. The most prominent features are acquired penile curvature, palpable plaques, erectile dysfunction, and pain during erections. […] Penile ultrasonography is the imaging method of choice for plaque location, measurement, and confirmation of calcification. Doppler ultrasound can be utilized to assess vascular function, which is useful in the evaluation of associated erectile dysfunction. […] Imaging also helps to differentiate PD from congenital penile curvature, penile fracture, or neoplastic disease. MRI can be employed in severe ones, although it is generally not required.

• #4 Peyronie’s Disease Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/peyronies-disease-guideline

  5. The clinician should engage in a diagnostic process to document the signs and symptoms that characterize Peyronie’s disease. The minimum requirements for this examination are a careful history (to assess penile deformity, interference with intercourse, penile pain, and/or distress) and a physical exam of the genitalia (to assess for palpable abnormalities of the penis). (Clinical Principle) […] 6. Clinicians should perform an in-office intracavernosal injection (ICI) test with or without duplex Doppler ultrasound prior to invasive intervention. (Expert Opinion) […] 7. Clinicians should evaluate and treat a man with Peyronie’s disease only when he/she has the experience and diagnostic tools to appropriately evaluate, counsel, and treat the condition. (Expert Opinion) […] 8. Clinicians should discuss with patients the available treatment options and the known benefits and risks/burdens associated with each treatment. (Clinical Principle)

• #5 Peyronie’s Disease Diagnosis: Understanding the Process and the Importance of Early Detection – Lakeview Center for Urology

  https://lakeviewurology.com/peyronies-disease-diagnosis/

  Peyronies Disease is a complex condition characterized by the development of fibrous scar tissue (plaque) inside the penis, leading to curvature, pain, and functional issues, particularly during erections. […] One of the most important aspects of managing Peyronies Disease is early diagnosis, which can help in identifying appropriate treatment options and potentially prevent the condition from worsening. […] Early diagnosis of Peyronies Disease is critical for several reasons: […] The stage at which Peyronies Disease is diagnosed can influence the available treatment options. […] Early diagnosis allows for more effective pain management strategies to be implemented, improving the patients quality of life. […] The first step in diagnosing Peyronies Disease is taking a detailed medical history.

• #6 Peyronie’s Disease: Diagnosis and Treatment

  https://getmegiddy.com/peyronies-disease-treated-diagnosed

  Peyronie’s disease is a condition of the penis that affects some men, typically those in their 40s or older, in which their erect penis changes shape. The primary symptom of the condition is that the erect penis develops with a new curve, bend or hourglass shape. […] Diagnosing Peyronie’s disease starts with some questions from your healthcare provider about the appearance of your erect penis. They might include the following: How long since you first noticed the bend in your penis? Do you think you’ve lost any length? If so, how much? How many degrees would you estimate the curve is? Does it make sex difficult or painful for you? For your partner? Do you experience erectile dysfunction (ED)? Typically, how firm are your erections? Do you know of any family history of Peyronie’s or Dupuytren contracture (another connective tissue disorder that may be correlated with Peyronie’s)?

• #7 Peyronie’s Disease: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/10044-peyronies-disease

  A healthcare provider can diagnose Peyronies disease. […] A healthcare provider can diagnose Peyronies disease. Theyll review your medical history and ask questions about your symptoms, which may include: […] A healthcare provider may recommend a penile duplex Doppler ultrasound examination to help diagnose Peyronies disease. An ultrasound is a type of imaging test that helps: […] The provider will also conduct a physical examination. During the physical exam, theyll feel the scarring in your penis. They may need to examine your penis when you have an erection. If necessary, they may give you an injection (vasoactive drug) that temporarily makes your penis erect.

• #8 Peyronie’s disease: a literature review on epidemiology, genetics, pathophysiology, diagnosis and work-up – Al-Thakafi – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10408/html

  The diagnosis of PD can be made using a combination of clinical history, physical examination and, sometimes, imaging modalities. […] A diagnosis of PD may be made on the basis of history, clinical examination, lab testing is not necessary and that imaging is only needed if an intervention is planned. […] The patients with PD can present with combination of following conditions: Pain in penis during erections; The curvature of the penis. The angulation can be noted during erection in some patients while, in some cases, palpable plaque can be noticed at the site of angulation even in a flaccid penis; An hourglass deformity caused at the site of the plaque due to the indentation in the penile shaft; Reduced erectile function due to loss of rigidity; Problems with intercourse due to penile buckling caused by the angulation.

• #9 Peyronie’s disease: a literature review on epidemiology, genetics, pathophysiology, diagnosis and work-up – Al-Thakafi – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10408/html

  PD can be classified into two phases, acute (active) and chronic (stable). The acute phase (active) of the condition is characterized by penile pain, minor curvature, and a nodule in the penis and onset of the pain may be associated with history of penile trauma during intercourse, the patient will be in distress due to this pain. […] The most common location for plaque in PD is the dorsal midline resulting in an upward bend of the erect penis. […] The diagnosis of PD is clinically determined by the patient’s history and penile examination. […] No specific blood tests are available for diagnosis of PD. […] Imaging of penile shaft is important in the diagnosis of PD in order to note calcification of the plaque as it signifies the end point of chronic PD after which no further angulation occurs.

• #10 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/penile-curvature

  Clinicians should take a focused history to distinguish between active and stable disease, as this will influence medical treatment and the timing of surgery. Patients who are still likely to have active disease are those with a shorter symptom duration, pain on erection, or a recent change in penile deformity. Resolution of pain and stability of the curvature for at least three months are accepted criteria of disease stabilisation as well as patients referral for specific medical therapy or surgical intervention, if indicated. […] The examination should start with a focused genital assessment that is extended to the hands and feet for detecting possible Dupuytrens contracture or Ledderhosen scarring of the plantar fascia. Penile examination is performed to assess the presence of a palpable nodule or plaque. There is no correlation between plaque size and degree of curvature. Measurement of the stretched or erect penile length is important because it may have an impact on the subsequent treatment decisions and potential medico-legal implications.

• #11 Peyronie disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/peyronies-disease/diagnosis-treatment/drc-20353473

  Health care professionals often can figure out if someone has Peyronie disease by doing a physical exam. They also might do tests to check for other conditions that can cause similar symptoms. […] You might need the following tests: […] Physical exam. Your health care professional feels your penis when it’s not erect to figure out the location and amount of scar tissue. The length of your penis also might be measured. If the condition becomes worse, this measurement helps determine whether the penis has gotten shorter. […] Your health care professional also might ask you to bring in photos of your erect penis taken at home. This can help determine the degree of curving, the location of scar tissue or other details that might guide treatment. […] Other tests. Your health care professional might order an ultrasound or other tests to check your penis when it’s erect. Before testing, you’ll likely receive a shot directly into the penis that helps it become erect. […] Ultrasound is the most commonly used test for penis conditions. It uses sound waves to make images of soft tissues inside the body. These tests can show the presence of scar tissue, blood flow to the penis and any other irregular signs.

• #12 What to Expect at Your Peyronie’s Disease Visit

  https://www.webmd.com/men/directories/peyronies-visit-expectations

  If youre dealing with penis pain or curvature changes, it could be Peyronies disease. […] Peyronies disease is based on the presence of scar tissue. (Its called plaque, but its not the same kind that can develop in your arteries.) Once the doctor can identify scar tissue in the penis and determine the extent of the issue, they can usually diagnose Peyronies disease. […] Doctors diagnose Peyronies disease by: Physical exam. Your doctor will feel your penis when it’s not erect to confirm the existence of scar tissue. […] Additional testing. Some doctors may want to rule out anything else or confirm that your issues are due to Peyronies disease. An ultrasound can give a better idea of whats going on inside your penis. […] Your doctor may ask to see you back at the office before making a diagnosis, or they may make a diagnosis on the spot. Once you confirm that you have Peyronies disease, you can start talking about possible treatments.

• #13 Peyronie disease: Diagnosis and Treatment

  http://www.urology-textbook.com/peyronies-treatment.html

  Diagnostic Workup for Peyronie Disease […] Physical examination: Location and size of the plaques. Documentation of stretched penile length before invasive therapy. Examination of hands and feet for concurrent fibrotic diseases. […] Photo documentation of the deviation […] Photo-documentation of the penile deviation is recommended before surgical treatment after self-stimulation or intracavernosal injection of prostaglandin. […] Sonography of the Penis […] Penile plaques can be seen with ultrasound imaging using a high-resolution linear transducer. The plaques are limited to the tunica albuginea, unlike sarcoma or other malignant penile diseases. Calcifications cause acoustic shadowing. […] Duplex (Doppler) Ultrasound Imaging of the Penile Blood Vessels […] Vascular testing is indicated for patients with erectile dysfunction and before invasive therapy. Documentation includes penile length, degree of penile deviation, and the vascular parameters during full erection. The most common cause of erectile dysfunction is veno-occlusive dysfunction. […] Cavernosography […] Cavernosography is seldom indicated in Peyronie disease. Cavernosography can diagnose veno-occlusive dysfunction, localize the venous leakage, and confirm the Doppler ultrasound findings.

• #14 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Peyronies-Disease-Diagnosis.aspx

  Peyronies Disease is a common, sexually debilitating fibrosing disorder of the penis that results in plaque formation and subsequent penile deformity. […] Therefore, it is pivotal to obtain all the necessary information from patients and conduct necessary diagnostic procedures in order to individually tailor treatment regimens. […] A review of a patient presenting with Peyronies disease should always include the duration of the condition and eventual presence or resolution of pain. […] A proper physical examination should entail a general appraisal of the femoral pulses, while the hands and feet should be thoroughly checked to confirm or exclude possible Dupuytrens contracture or Ledderhose disease (plantar fibromatosis). However, the most important part of physical evaluation is the inspection of the patients penis.

• #15 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/penile-curvature

  An objective assessment of penile curvature with an erection is mandatory. This can be obtained by several approaches, including home (self) photography of a natural erection (preferably), using a vacuum-assisted erection test or an ICI using vasoactive agents. However, it has been suggested that the ICI method is superior, as it is able to induce an erection similar to or better than that which the patient would experience when sexually aroused. […] Ultrasound measurement of plaque size is inaccurate and operator dependent. Doppler US may be used to assess penile haemodynamic and vascular anatomy. Intracavernous injection method is superior to other methods to provide an objective assessment of penile curvature with an erection. […] Take a medical and sexual history of patients with Peyronies disease (PD), include duration of the disease, pain on erection, penile deformity, difficulty in vaginal/anal intromission due to the deformity and erectile dysfunction (ED). Strong Perform a physical examination, including assessment of palpable plaques, stretched or erect penile length, degree of curvature (self-photography, vacuum-assisted erection test or pharmacological-induced erection) and any other related diseases (e.g., Dupuytrens contracture, Ledderhose disease) in patients with PD. Strong Use the intracavernous injection method in the diagnostic work-up of PD to provide an objective assessment of penile curvature with an erection. Weak Do not use ultrasound (US), computed tomography or magnetic resonance imaging to assess plaque size and deformity in routine clinical practice. Weak Use penile Doppler US in the case of diagnostic evaluation of ED, to evaluate penile haemodynamic and vascular anatomy, and to assess location and calcification of plaques, especially prior to surgery. Weak

• #16 Peyronie Disease Workup: Laboratory Studies, Imaging Studies, Diagnostic Procedures

  https://emedicine.medscape.com/article/456574-workup

  If erectile dysfunction (ED) is associated with the PD, then duplex ultrasonography with intracavernous injections of a vasoactive agent, such as alprostadil, and/or dynamic infusion cavernosometry and cavernosography may be indicated to help identify associated arteriogenic ED or corporeal veno-occlusive dysfunction. […] Duplex ultrasonography with intracavernous injection has become popular in helping to delineate the extent of the Peyronie plaque, to evaluate for any hour-glass deformity in the shaft, and to quantify the extent and direction of penile angulation. […] The authors emphasized the need for objective measurement of penile angulation in order to accurately counsel patients regarding disease severity and appropriate therapy and to objectively assess treatment outcome. […] Measuring the length of the penis before intervention is also important. The stretched length of the flaccid penis from the base to the tip should be recorded. […] If the penis does not achieve full erection during the test, then the physician has also documented associated ED, and the recommended treatment can be appropriately adjusted to address both problems.

• #17 Peyronie’s Treatment in Houston, TX | Jonathan Clavell, MD

  https://houstonmenshealth.com/conditions/peyronies-disease/

  Peyronies disease is diagnosed with a thorough history and physical exam. Dr. Clavell will ask you specific questions about your medical history, sexual history and timing of your symptoms. Then a physical exam is performed in order to identify any presence of scar tissue in the penis. The penis is palpated when the penis is not erect, to identify the location and amount of scar tissue. […] Dr. Clavell may also ask you to bring in photos of your erect penis taken at home. Ideally, a picture of the erection from both ABOVE and THE SIDE are best to determine the degree of curvature and other details that will help identify the best treatment option for you. […] In certain occasions, Dr. Clavell may order a penile ultrasound to help characterize the plaque inside the penis. Depending on your erectile function, the penis is injected to cause an erection and better identify the characteristics of your curvature.

• #18 Peyronie’s Disease | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/peyronies-disease

  A diagnosis of Peyronie’s disease usually can be made by taking a detailed medical history and conducting a thorough physical examination. Your doctor will check for and discuss any symptoms that are related to the disease. In some instances, an ultrasound scan may be used to identify the hardened plaque in the penis. […] We recommend that patients bring photographs from a digital or polaroid camera of the erect penis taken from above and both sides, if possible. These can be very helpful in making a diagnosis. […] In rare cases where a diagnosis of Peyronie’s disease cannot be made through physical examination, a biopsy may be recommended. During a biopsy, a small amount of plaque cells are removed from the penis and then examined under a microscope to help diagnose the condition and rule out other diseases, such as cancer.

• #19 Peyronie disease: Diagnosis and Treatment

  http://www.urology-textbook.com/peyronies-treatment.html

  Diagnostic Workup for Peyronie Disease […] Physical examination: Location and size of the plaques. Documentation of stretched penile length before invasive therapy. Examination of hands and feet for concurrent fibrotic diseases. […] Photo documentation of the deviation […] Photo-documentation of the penile deviation is recommended before surgical treatment after self-stimulation or intracavernosal injection of prostaglandin. […] Sonography of the Penis […] Penile plaques can be seen with ultrasound imaging using a high-resolution linear transducer. The plaques are limited to the tunica albuginea, unlike sarcoma or other malignant penile diseases. Calcifications cause acoustic shadowing. […] Duplex (Doppler) Ultrasound Imaging of the Penile Blood Vessels […] Vascular testing is indicated for patients with erectile dysfunction and before invasive therapy. Documentation includes penile length, degree of penile deviation, and the vascular parameters during full erection. The most common cause of erectile dysfunction is veno-occlusive dysfunction. […] Cavernosography […] Cavernosography is seldom indicated in Peyronie disease. Cavernosography can diagnose veno-occlusive dysfunction, localize the venous leakage, and confirm the Doppler ultrasound findings.

• #20 Peyronie disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/peyronies-disease/diagnosis-treatment/drc-20353473

  Health care professionals often can figure out if someone has Peyronie disease by doing a physical exam. They also might do tests to check for other conditions that can cause similar symptoms. […] You might need the following tests: […] Physical exam. Your health care professional feels your penis when it’s not erect to figure out the location and amount of scar tissue. The length of your penis also might be measured. If the condition becomes worse, this measurement helps determine whether the penis has gotten shorter. […] Your health care professional also might ask you to bring in photos of your erect penis taken at home. This can help determine the degree of curving, the location of scar tissue or other details that might guide treatment. […] Other tests. Your health care professional might order an ultrasound or other tests to check your penis when it’s erect. Before testing, you’ll likely receive a shot directly into the penis that helps it become erect. […] Ultrasound is the most commonly used test for penis conditions. It uses sound waves to make images of soft tissues inside the body. These tests can show the presence of scar tissue, blood flow to the penis and any other irregular signs.

• #21 Peyronie’s Disease Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/peyronies-disease-guideline

  5. The clinician should engage in a diagnostic process to document the signs and symptoms that characterize Peyronie’s disease. The minimum requirements for this examination are a careful history (to assess penile deformity, interference with intercourse, penile pain, and/or distress) and a physical exam of the genitalia (to assess for palpable abnormalities of the penis). (Clinical Principle) […] 6. Clinicians should perform an in-office intracavernosal injection (ICI) test with or without duplex Doppler ultrasound prior to invasive intervention. (Expert Opinion) […] 7. Clinicians should evaluate and treat a man with Peyronie’s disease only when he/she has the experience and diagnostic tools to appropriately evaluate, counsel, and treat the condition. (Expert Opinion) […] 8. Clinicians should discuss with patients the available treatment options and the known benefits and risks/burdens associated with each treatment. (Clinical Principle)

• #22 Peyronie Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560628/

  The most critical components of the evaluation are the patient’s history and a thorough physical examination. There is no mandatory or necessary laboratory or imaging testing to complete a Peyronie disease workup. […] The American Urological Association (AUA), Canadian Urological Association (CUA), and the European Association of Urology (EAU) guidelines recommend performing an in-office intracavernous injection (ICI) test with or without penile Doppler duplex ultrasound before any invasive intervention. […] Clinicians should assess and treat men with Peyronie disease only when they have the experience and diagnostic tools to evaluate, appropriately counsel, and treat the condition. […] The patient’s distress over his symptoms, level of concern, and willingness to undergo various types of treatment should be fully considered in the decision-making process, in addition to any objective measures of curvature and erectile function. […] Surgery is the durable and effective treatment for symptomatic Peyronie disease, particularly when severe enough to prevent intercourse and where less invasive therapies have failed.

• #23 Peyronie’s disease: a literature review on epidemiology, genetics, pathophysiology, diagnosis and work-up – Al-Thakafi – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10408/html

  PD can be classified into two phases, acute (active) and chronic (stable). The acute phase (active) of the condition is characterized by penile pain, minor curvature, and a nodule in the penis and onset of the pain may be associated with history of penile trauma during intercourse, the patient will be in distress due to this pain. […] The most common location for plaque in PD is the dorsal midline resulting in an upward bend of the erect penis. […] The diagnosis of PD is clinically determined by the patient’s history and penile examination. […] No specific blood tests are available for diagnosis of PD. […] Imaging of penile shaft is important in the diagnosis of PD in order to note calcification of the plaque as it signifies the end point of chronic PD after which no further angulation occurs.

• #24 Peyronie’s disease – Wikipedia

  https://en.wikipedia.org/wiki/Peyronie%27s_disease

  Peyronie’s disease diagnosis is mostly clinical. Patient history and physical examination are crucial. The most prominent features are acquired penile curvature, palpable plaques, erectile dysfunction, and pain during erections. […] Penile ultrasonography is the imaging method of choice for plaque location, measurement, and confirmation of calcification. Doppler ultrasound can be utilized to assess vascular function, which is useful in the evaluation of associated erectile dysfunction. […] Imaging also helps to differentiate PD from congenital penile curvature, penile fracture, or neoplastic disease. MRI can be employed in severe ones, although it is generally not required.

• #25 Peyronie disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/peyronies-disease/diagnosis-treatment/drc-20353473

  Health care professionals often can figure out if someone has Peyronie disease by doing a physical exam. They also might do tests to check for other conditions that can cause similar symptoms. […] You might need the following tests: […] Physical exam. Your health care professional feels your penis when it’s not erect to figure out the location and amount of scar tissue. The length of your penis also might be measured. If the condition becomes worse, this measurement helps determine whether the penis has gotten shorter. […] Your health care professional also might ask you to bring in photos of your erect penis taken at home. This can help determine the degree of curving, the location of scar tissue or other details that might guide treatment. […] Other tests. Your health care professional might order an ultrasound or other tests to check your penis when it’s erect. Before testing, you’ll likely receive a shot directly into the penis that helps it become erect. […] Ultrasound is the most commonly used test for penis conditions. It uses sound waves to make images of soft tissues inside the body. These tests can show the presence of scar tissue, blood flow to the penis and any other irregular signs.

• #26

  https://journals.lww.com/co-urology/fulltext/2020/05000/the_role_of_imaging_in_the_diagnosis_and.2.aspx

  Several imaging modalities exist for the assessment of Peyronie’s disease. However, comprehensive recommendations for using these objective modalities based on large-scale evidence-based studies do not yet exist. Our objective is to evaluate current imaging techniques and provide a model that we follow in our clinic in the workup and management of Peyronie’s disease. […] Ultrasonography is the preferred imaging modality in Peyronie’s disease and noninvasively characterizes penile plaques and monitors plaque response to various treatments. At our center, we perform ultrasonography with intracavernosal injection in all patients with Peyronie’s disease to evaluate the degree of curvature, plaque characteristics, and concomitant erectile dysfunction to better guide management decisions.

• #27 How Peyronie’s Disease Is Diagnosed

  https://www.verywellhealth.com/peyronies-disease-diagnosis-4688592

  The first test for Peyronie’s disease is the healthcare provider palpating the flaccid penis. […] To test the extent of your Peyronie’s disease, your healthcare provider may also use the Peyronie’s Disease Questionnaire (PDQ). […] This test is usually done on the erect penis. […] Ultrasound is the major type of imaging used to diagnose Peyronie’s disease. […] Your healthcare provider uses ultrasound of your erect penis to look for any issues with blood flow that could point to other problems that can affect erectile function. […] High-resolution ultrasound can also be used to identify the plaques and scarring that are the hallmark of Peyronie’s disease.

• #28 Peyronie Disease Workup: Laboratory Studies, Imaging Studies, Diagnostic Procedures

  https://emedicine.medscape.com/article/456574-workup

  If erectile dysfunction (ED) is associated with the PD, then duplex ultrasonography with intracavernous injections of a vasoactive agent, such as alprostadil, and/or dynamic infusion cavernosometry and cavernosography may be indicated to help identify associated arteriogenic ED or corporeal veno-occlusive dysfunction. […] Duplex ultrasonography with intracavernous injection has become popular in helping to delineate the extent of the Peyronie plaque, to evaluate for any hour-glass deformity in the shaft, and to quantify the extent and direction of penile angulation. […] The authors emphasized the need for objective measurement of penile angulation in order to accurately counsel patients regarding disease severity and appropriate therapy and to objectively assess treatment outcome. […] Measuring the length of the penis before intervention is also important. The stretched length of the flaccid penis from the base to the tip should be recorded. […] If the penis does not achieve full erection during the test, then the physician has also documented associated ED, and the recommended treatment can be appropriately adjusted to address both problems.

• #29 Peyronie’s Disease – Brigham and Women’s Faulkner Hospital

  https://www.brighamandwomensfaulkner.org/programs-and-services/urology/mens-health/peyronies-disease

  A diagnosis of Peyronies disease is usually made when men seek medical attention for painful erections and difficulty with intercourse. In addition to a complete medical history and physical examination, diagnostic procedures for Peyronies disease may include the following: […] Ultrasound examination of the penis: A diagnostic technique that uses high-frequency sound waves to create an image of the internal organs. […] Color Doppler examination: A type of ultrasound that uses sound waves to measure the flow of blood through a blood vessel; waveforms of the blood flow are shown on the ultrasound screen (to evaluate erectile function, anatomy and blood flow).

• #30 Peyronie disease | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/peyronie-disease-1?lang=us

  Peyronie disease is the most common cause of painful penile induration. Fibrous tissue plaques form within the penile tunica albuginea, causing painful deformity and shortening of the penis. Though clinical diagnosis is usually accurate, the role of imaging is to evaluate extension of plaques, whether the penile septum is involved, and to examine the relationship between the plaques and the penile vasculature. […] Ultrasound can detect the relationship of plaques to surrounding structures. For instance, involvement of the neurovascular bundle is important, which can be seen as plaque embedded within the dorsal arteries. Cavernosal artery encasement may be seen in cases of septal plaques. This arterial encasement can lead to erectile dysfunction (arteriogenic). […] CT is not employed in the investigation of Peyronie disease. If CT is performed for other reasons, plaques may be seen (especially if they exhibit calcification).

• #31 Peyronie disease: Diagnosis and Treatment

  http://www.urology-textbook.com/peyronies-treatment.html

  Diagnostic Workup for Peyronie Disease […] Physical examination: Location and size of the plaques. Documentation of stretched penile length before invasive therapy. Examination of hands and feet for concurrent fibrotic diseases. […] Photo documentation of the deviation […] Photo-documentation of the penile deviation is recommended before surgical treatment after self-stimulation or intracavernosal injection of prostaglandin. […] Sonography of the Penis […] Penile plaques can be seen with ultrasound imaging using a high-resolution linear transducer. The plaques are limited to the tunica albuginea, unlike sarcoma or other malignant penile diseases. Calcifications cause acoustic shadowing. […] Duplex (Doppler) Ultrasound Imaging of the Penile Blood Vessels […] Vascular testing is indicated for patients with erectile dysfunction and before invasive therapy. Documentation includes penile length, degree of penile deviation, and the vascular parameters during full erection. The most common cause of erectile dysfunction is veno-occlusive dysfunction. […] Cavernosography […] Cavernosography is seldom indicated in Peyronie disease. Cavernosography can diagnose veno-occlusive dysfunction, localize the venous leakage, and confirm the Doppler ultrasound findings.

• #32 Peyronie’s Disease Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/peyronies-disease-guideline

  1. The purpose of this guideline is to provide a clinical framework for the diagnosis and treatment of Peyronie’s disease (PD). […] 2. Clinicians should engage in a diagnostic process to document the signs and symptoms that characterize Peyronie’s disease. The minimum requirements for this examination are a careful history (to assess penile deformity, interference with intercourse, penile pain, and/or distress) and a physical exam of the genitalia (to assess for palpable abnormalities of the penis). (Clinical Principle) […] 3. Clinicians should perform an in-office intracavernosal injection (ICI) test with or without duplex Doppler ultrasound prior to invasive intervention. (Expert Opinion) […] 4. Clinicians should evaluate and treat a man with Peyronie’s disease only when he/she has the experience and diagnostic tools to appropriately evaluate, counsel, and treat the condition. (Expert Opinion)

• #33 Peyronie’s disease – Watch out for the bend

  https://www.racgp.org.au/afp/2017/september/peyronies-disease

  Diagnosis of Peyronies disease is readily made by a typical history and penile examination. Clinically important information includes: […] Diagnosis of Peyronies disease is largely based on history and examination, and specific investigation, at the general practice level, is not usually indicated. […] When referred to a specialist, the urologist may undertake a duplex Doppler ultrasound combined with an intracavernosal vasoactive agent. This allows the urologist to objectively measure the patients penile blood flow parameters, the penile curvature and other deformities, and plaque characteristic (eg calcification). These parameters can help direct treatment options. […] The most important part of treatment for Peyronies disease is to set appropriate expectations. Peyronies disease is a clinical diagnosis and definitive treatment is reserved for the stable phase of the condition. Intralesional collagenase is the only nonsurgical treatment that has good evidence to suggest that it may offer modest improvement in penile curvature. […] Surgical correction of Peyronies disease remains the only treatment that will give a functionally straight penis in the majority of patients.

• #34 Peyronie Disease Workup: Laboratory Studies, Imaging Studies, Diagnostic Procedures

  https://emedicine.medscape.com/article/456574-workup

  No specific blood test is available for Peyronie disease (PD). Although an association exists between PD and HLA-B7 surface antigen, it is not a specific marker for this disease. Also, identifying this marker in order to diagnose PD is not practical because the diagnosis should be obvious from the history and physical examination findings. […] The main objective of imaging studies in a patient with PD is to identify calcification of the plaque, because this endpoint usually signifies maturity of the plaque, indicating that further angulation should not occur. The following imaging methods may be used: […] MRI of the penis has been used to image the plaque while it is still composed of fibrous tissue. Although MRI is not the preferred imaging technique because of cost and availability, it may prove helpful in questionable cases.

• #35 Peyronie disease | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/peyronie-disease-1?lang=us

  Peyronie disease is the most common cause of painful penile induration. Fibrous tissue plaques form within the penile tunica albuginea, causing painful deformity and shortening of the penis. Though clinical diagnosis is usually accurate, the role of imaging is to evaluate extension of plaques, whether the penile septum is involved, and to examine the relationship between the plaques and the penile vasculature. […] Ultrasound can detect the relationship of plaques to surrounding structures. For instance, involvement of the neurovascular bundle is important, which can be seen as plaque embedded within the dorsal arteries. Cavernosal artery encasement may be seen in cases of septal plaques. This arterial encasement can lead to erectile dysfunction (arteriogenic). […] CT is not employed in the investigation of Peyronie disease. If CT is performed for other reasons, plaques may be seen (especially if they exhibit calcification).

• #36 Peyronie disease | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/peyronie-disease-1?lang=us

  Plaques appear as thickened and hypointense signal areas on T1 and T2 weighted images, in and around the tunica albuginea. They are usually best seen on T2 weighted images. Albugineal calcifications are difficult to recognize on MRI. […] The use of contrast enhancement for diagnosis is controversial.

• #37 Peyronie’s Disease: Current Management | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/0801/p549.html

  Radiographs of the penis may show calcification in 20 to 25 percent of patients with end-stage disease, and 25 percent of these patients have frank bone. […] Doppler flow studies and results of dynamic infusion cavernosometry and cavernosography are normal both proximal and distal to the plaque, demonstrating that disparity in the erection is not associated with lack of blood flow at or beyond the lesion.

• #38 Peyronie disease: Diagnosis and Treatment

  http://www.urology-textbook.com/peyronies-treatment.html

  Diagnostic Workup for Peyronie Disease […] Physical examination: Location and size of the plaques. Documentation of stretched penile length before invasive therapy. Examination of hands and feet for concurrent fibrotic diseases. […] Photo documentation of the deviation […] Photo-documentation of the penile deviation is recommended before surgical treatment after self-stimulation or intracavernosal injection of prostaglandin. […] Sonography of the Penis […] Penile plaques can be seen with ultrasound imaging using a high-resolution linear transducer. The plaques are limited to the tunica albuginea, unlike sarcoma or other malignant penile diseases. Calcifications cause acoustic shadowing. […] Duplex (Doppler) Ultrasound Imaging of the Penile Blood Vessels […] Vascular testing is indicated for patients with erectile dysfunction and before invasive therapy. Documentation includes penile length, degree of penile deviation, and the vascular parameters during full erection. The most common cause of erectile dysfunction is veno-occlusive dysfunction. […] Cavernosography […] Cavernosography is seldom indicated in Peyronie disease. Cavernosography can diagnose veno-occlusive dysfunction, localize the venous leakage, and confirm the Doppler ultrasound findings.

• #39 How Peyronie’s Disease Is Diagnosed

  https://www.verywellhealth.com/peyronies-disease-diagnosis-4688592

  The first test for Peyronie’s disease is the healthcare provider palpating the flaccid penis. […] To test the extent of your Peyronie’s disease, your healthcare provider may also use the Peyronie’s Disease Questionnaire (PDQ). […] This test is usually done on the erect penis. […] Ultrasound is the major type of imaging used to diagnose Peyronie’s disease. […] Your healthcare provider uses ultrasound of your erect penis to look for any issues with blood flow that could point to other problems that can affect erectile function. […] High-resolution ultrasound can also be used to identify the plaques and scarring that are the hallmark of Peyronie’s disease.

• #40 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/penile-curvature

  Taking a medical and sexual history is usually sufficient to establish a diagnosis of CPC. Patients usually present after reaching puberty as the curvature becomes more apparent with erections and sexual activity. The more severe curvatures can make intercourse difficult or impossible. Physical examination and photographic documentation during erection (preferably after intracavernous injection [ICI] of vasoactive drugs) are both mandatory to document the curvature and exclude other pathologies. […] The aim of the initial evaluation is to obtain information on the presenting symptoms and their duration (e.g., pain on erection, palpable nodules, deformity, length and girth and erectile function). It is important to obtain information on the distress caused by the symptoms and the potential risk factors for ED and PD. A disease-specific questionnaire (Peyronies disease questionnaire [PDQ]) has been developed for use in clinical practice and trials. The Peyronies disease questionnaire measures three domains, including psychological and physical symptoms, penile pain and symptom bother.

• #41 Straight Talk: A Guide to Understanding Peyronie’s Disease (Causes, Symptoms, Diagnosis and Treatments)

  https://thrivesexualwellness.com/peyronies-disease-causes-symptoms-diagnosis/

  Peyronie’s Disease Diagnosis: […] It’s always best to seek a medical diagnosis if you’re concerned that you have Peyronie’s disease. […] You may not experience every symptom on this questionnaire. Still, if you have one or more of these Peyronie’s disease symptoms, you should talk to your primary care provider or urologist. […] Your healthcare provider or urologist will order the following kinds of tests to determine if you have Peyronie’s disease: […] This is generally the first test you will undergo, where the specialist palpitates the flaccid penis. Next, the specialist will locate indentations, bumps, or hard tissue on the penis. […] Your specialist also uses a medical questionnaire called the Peyronie’s disease Questionnaire (PDQ), a 15-item list with psychological and physical questions you will answer.

• #42 Peyronie’s disease – Wikipedia

  https://en.wikipedia.org/wiki/Peyronie%27s_disease

  Peyronie’s disease diagnosis is mostly clinical. Patient history and physical examination are crucial. The most prominent features are acquired penile curvature, palpable plaques, erectile dysfunction, and pain during erections. […] Penile ultrasonography is the imaging method of choice for plaque location, measurement, and confirmation of calcification. Doppler ultrasound can be utilized to assess vascular function, which is useful in the evaluation of associated erectile dysfunction. […] Imaging also helps to differentiate PD from congenital penile curvature, penile fracture, or neoplastic disease. MRI can be employed in severe ones, although it is generally not required.

• #43 What to Expect at Your Peyronie’s Disease Visit

  https://www.webmd.com/men/directories/peyronies-visit-expectations

  If youre dealing with penis pain or curvature changes, it could be Peyronies disease. […] Peyronies disease is based on the presence of scar tissue. (Its called plaque, but its not the same kind that can develop in your arteries.) Once the doctor can identify scar tissue in the penis and determine the extent of the issue, they can usually diagnose Peyronies disease. […] Doctors diagnose Peyronies disease by: Physical exam. Your doctor will feel your penis when it’s not erect to confirm the existence of scar tissue. […] Additional testing. Some doctors may want to rule out anything else or confirm that your issues are due to Peyronies disease. An ultrasound can give a better idea of whats going on inside your penis. […] Your doctor may ask to see you back at the office before making a diagnosis, or they may make a diagnosis on the spot. Once you confirm that you have Peyronies disease, you can start talking about possible treatments.

• #44 Peyronie’s Disease | Urology | UPMC

  https://www.upmc.com/services/urology/conditions/peyronies-disease

  Diagnosing this condition begins with a physical exam and medical history. Your doctor will ask about your symptoms and family history, and they will likely do a physical exam. They may inject a drug into the penis to make it erect, allowing your doctor to see where the scar tissue has built up. Your doctor may also order imaging tests, such as: […] Imaging tests also help your doctor make a diagnosis by excluding other possible causes of your symptoms.

• #45 Peyronie’s Disease | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/peyronies-disease

  A diagnosis of Peyronie’s disease usually can be made by taking a detailed medical history and conducting a thorough physical examination. Your doctor will check for and discuss any symptoms that are related to the disease. In some instances, an ultrasound scan may be used to identify the hardened plaque in the penis. […] We recommend that patients bring photographs from a digital or polaroid camera of the erect penis taken from above and both sides, if possible. These can be very helpful in making a diagnosis. […] In rare cases where a diagnosis of Peyronie’s disease cannot be made through physical examination, a biopsy may be recommended. During a biopsy, a small amount of plaque cells are removed from the penis and then examined under a microscope to help diagnose the condition and rule out other diseases, such as cancer.

• #46 Peyronie’s Disease: Diagnosis and Treatment

  https://getmegiddy.com/peyronies-disease-treated-diagnosed

  Your healthcare provider will probably perform a physical exam, feeling for the spot where the scar tissue is. They may order a Doppler ultrasound exam to help pinpoint exactly where the scarring is, check for a buildup of calcium and determine how the blood is flowing in your penis. […] It’s possible your provider will need to examine your penis in its erect state before being able to make a recommendation for treatment. They may ask you to take a picture of it at home, or they may give you a medication that will make it erect at your appointment. […] „The first thing you need to do is establish if the patient is in the acute phase or the stable phase of Peyronie’s disease,” said Neel Parekh, M.D., a men’s fertility and sexual health specialist with Cleveland Clinic. „Typically, we don’t recommend any kind of invasive treatment in that time, because there are still changes occurring to that plaque and to the curvature. So, we typically recommend conservative management, which can be stressful for a lot of guys.”

• #47 Peyronie’s disease: a literature review on epidemiology, genetics, pathophysiology, diagnosis and work-up – Al-Thakafi – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10408/html

  PD can be classified into two phases, acute (active) and chronic (stable). The acute phase (active) of the condition is characterized by penile pain, minor curvature, and a nodule in the penis and onset of the pain may be associated with history of penile trauma during intercourse, the patient will be in distress due to this pain. […] The most common location for plaque in PD is the dorsal midline resulting in an upward bend of the erect penis. […] The diagnosis of PD is clinically determined by the patient’s history and penile examination. […] No specific blood tests are available for diagnosis of PD. […] Imaging of penile shaft is important in the diagnosis of PD in order to note calcification of the plaque as it signifies the end point of chronic PD after which no further angulation occurs.

• #48 Peyronie’s disease: a literature review on epidemiology, genetics, pathophysiology, diagnosis and work-up – Al-Thakafi – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10408/html

  PD can be classified into two phases, acute (active) and chronic (stable). The acute phase (active) of the condition is characterized by penile pain, minor curvature, and a nodule in the penis and onset of the pain may be associated with history of penile trauma during intercourse, the patient will be in distress due to this pain. […] The most common location for plaque in PD is the dorsal midline resulting in an upward bend of the erect penis. […] The diagnosis of PD is clinically determined by the patient’s history and penile examination. […] No specific blood tests are available for diagnosis of PD. […] Imaging of penile shaft is important in the diagnosis of PD in order to note calcification of the plaque as it signifies the end point of chronic PD after which no further angulation occurs.

• #49 Peyronie’s Disease Diagnosis: Understanding the Process and the Importance of Early Detection – Lakeview Center for Urology

  https://lakeviewurology.com/peyronies-disease-diagnosis/

  Understanding the patients medical history provides valuable insight into the likely causes and progression of Peyronies Disease, helping the doctor determine the best approach for further evaluation and treatment. […] After taking the medical history, the next step in the diagnostic process is a physical examination. […] In some cases, doctors may use imaging tests to further evaluate Peyronies Disease. […] The most commonly used imaging technique is ultrasound. […] Since Peyronies Disease can lead to erectile dysfunction, doctors may also assess erectile function as part of the diagnostic process. […] Accurate staging of the disease is crucial for determining the appropriate treatment plan. […] Understanding the stage of Peyronies Disease allows the doctor to tailor treatment options accordingly.

• #50 Peyronie Disease: Practice Essentials, Problem, Epidemiology

  https://emedicine.medscape.com/article/456574-overview

  Peyronie disease (PD) is characterized by curvature in the penile shaft that is often preceded by painful erections and accompanied by an area of fibrosis. […] This article defines the problem of PD, outlines a reasonable evaluation of patients with PD, reviews the medical therapies that have been used, and presents the surgical options that are currently available. […] If Peyronie disease (PD) is diagnosed early in the disease course (ie, within the first 6 mo of the onset of any symptoms), attempt nonsurgical therapy. […] Waiting for a sufficient duration after the inception of symptoms is necessary to ensure that the condition is stable and to be certain that spontaneous resolution will not occur. […] If the plaque and/or penile angulation have remained unchanged for 6 months, the condition can be assumed to be stable and surgical intervention can be contemplated. […] Surgery should not be undertaken unless the condition is debilitating, preventing satisfactory intercourse.

• #51 Peyronie’s disease: a literature review on epidemiology, genetics, pathophysiology, diagnosis and work-up – Al-Thakafi – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10408/html

  PD can be classified into two phases, acute (active) and chronic (stable). The acute phase (active) of the condition is characterized by penile pain, minor curvature, and a nodule in the penis and onset of the pain may be associated with history of penile trauma during intercourse, the patient will be in distress due to this pain. […] The most common location for plaque in PD is the dorsal midline resulting in an upward bend of the erect penis. […] The diagnosis of PD is clinically determined by the patient’s history and penile examination. […] No specific blood tests are available for diagnosis of PD. […] Imaging of penile shaft is important in the diagnosis of PD in order to note calcification of the plaque as it signifies the end point of chronic PD after which no further angulation occurs.

• #52 Peyronie’s Disease Diagnosis: Understanding the Process and the Importance of Early Detection – Lakeview Center for Urology

  https://lakeviewurology.com/peyronies-disease-diagnosis/

  Understanding the patients medical history provides valuable insight into the likely causes and progression of Peyronies Disease, helping the doctor determine the best approach for further evaluation and treatment. […] After taking the medical history, the next step in the diagnostic process is a physical examination. […] In some cases, doctors may use imaging tests to further evaluate Peyronies Disease. […] The most commonly used imaging technique is ultrasound. […] Since Peyronies Disease can lead to erectile dysfunction, doctors may also assess erectile function as part of the diagnostic process. […] Accurate staging of the disease is crucial for determining the appropriate treatment plan. […] Understanding the stage of Peyronies Disease allows the doctor to tailor treatment options accordingly.

• #53 Peyronie Disease: Practice Essentials, Problem, Epidemiology

  https://emedicine.medscape.com/article/456574-overview

  Peyronie disease (PD) is characterized by curvature in the penile shaft that is often preceded by painful erections and accompanied by an area of fibrosis. […] This article defines the problem of PD, outlines a reasonable evaluation of patients with PD, reviews the medical therapies that have been used, and presents the surgical options that are currently available. […] If Peyronie disease (PD) is diagnosed early in the disease course (ie, within the first 6 mo of the onset of any symptoms), attempt nonsurgical therapy. […] Waiting for a sufficient duration after the inception of symptoms is necessary to ensure that the condition is stable and to be certain that spontaneous resolution will not occur. […] If the plaque and/or penile angulation have remained unchanged for 6 months, the condition can be assumed to be stable and surgical intervention can be contemplated. […] Surgery should not be undertaken unless the condition is debilitating, preventing satisfactory intercourse.

• #54 Peyronie’s Disease | Center for Urologic Care of Berks County

  https://www.centerforurologiccare.com/patient-education/peyronies-disease/

  When you come see us, well start by asking you about your medical history, especially about your penis health. […] Well also do a physical exam and check your penis for plaques. We will also plan an intracavernosal injection test (also called an ICI test). […] You might also have a duplex Doppler ultrasound. This imaging test uses sound waves to show us where the plaques are and how well blood is flowing in your penis. […] It may take 12 months or even longer to have stable disease. […] According to Peyronies disease treatment guidelines set forth by the American Urological Association (AUA), ESWT may be appropriate for the treatment of penile pain, but it is not recommended for decreasing penile curvature or reducing plaque size.

• #55 Peyronie’s Disease

  https://www.dcurology.net/common-problems/peyronies-disease.php

  Peyronies disease results from scarring of the tough tissue called the tunica albuginea that comprises the two erectile bodies of the penis, known as the corpora cavernosa. […] Once noticed, many patients seek advice from a Urologist, largely seeking reassurance. […] Generally, the first real steps include medicine injections directly into the plaque to soften the scar. […] Injection therapy is the first line of treatment for Peyronies Disease before surgery. If injection therapy fails, surgery in the form of plication or incision and grafting may be considered as a last resort.

• #56 Peyronie Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560628/

  Peyronie disease is a benign disorder causing pain and curvature of the penis during erections. This activity reviews the etiology, pathophysiology, epidemiology, diagnosis, and treatment options for Peyronie disease, encompassing both surgical and nonsurgical approaches. The currently recommended evaluation and management strategies for this disorder are presented, highlighting the role of the interprofessional team in ensuring the best possible patient outcomes. […] Obtaining a detailed history and performing a thorough physical examination is crucial for accurately diagnosing Peyronie disease. […] Accurate evaluation of penile deformity is critical for determining a baseline and planning treatment. The penis should be examined in flaccid and erect states to provide a clearer understanding of the extent of the deformity and corroboration with the patient’s experience.

• #57 Peyronie’s Disease Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/peyronies-disease-guideline

  1. The purpose of this guideline is to provide a clinical framework for the diagnosis and treatment of Peyronie’s disease (PD). […] 2. Clinicians should engage in a diagnostic process to document the signs and symptoms that characterize Peyronie’s disease. The minimum requirements for this examination are a careful history (to assess penile deformity, interference with intercourse, penile pain, and/or distress) and a physical exam of the genitalia (to assess for palpable abnormalities of the penis). (Clinical Principle) […] 3. Clinicians should perform an in-office intracavernosal injection (ICI) test with or without duplex Doppler ultrasound prior to invasive intervention. (Expert Opinion) […] 4. Clinicians should evaluate and treat a man with Peyronie’s disease only when he/she has the experience and diagnostic tools to appropriately evaluate, counsel, and treat the condition. (Expert Opinion)

• #58 Peyronie’s Disease Diagnosis: Understanding the Process and the Importance of Early Detection – Lakeview Center for Urology

  https://lakeviewurology.com/peyronies-disease-diagnosis/

  Understanding the patients medical history provides valuable insight into the likely causes and progression of Peyronies Disease, helping the doctor determine the best approach for further evaluation and treatment. […] After taking the medical history, the next step in the diagnostic process is a physical examination. […] In some cases, doctors may use imaging tests to further evaluate Peyronies Disease. […] The most commonly used imaging technique is ultrasound. […] Since Peyronies Disease can lead to erectile dysfunction, doctors may also assess erectile function as part of the diagnostic process. […] Accurate staging of the disease is crucial for determining the appropriate treatment plan. […] Understanding the stage of Peyronies Disease allows the doctor to tailor treatment options accordingly.

• #59 Peyronie Disease Workup: Laboratory Studies, Imaging Studies, Diagnostic Procedures

  https://emedicine.medscape.com/article/456574-workup

  If erectile dysfunction (ED) is associated with the PD, then duplex ultrasonography with intracavernous injections of a vasoactive agent, such as alprostadil, and/or dynamic infusion cavernosometry and cavernosography may be indicated to help identify associated arteriogenic ED or corporeal veno-occlusive dysfunction. […] Duplex ultrasonography with intracavernous injection has become popular in helping to delineate the extent of the Peyronie plaque, to evaluate for any hour-glass deformity in the shaft, and to quantify the extent and direction of penile angulation. […] The authors emphasized the need for objective measurement of penile angulation in order to accurately counsel patients regarding disease severity and appropriate therapy and to objectively assess treatment outcome. […] Measuring the length of the penis before intervention is also important. The stretched length of the flaccid penis from the base to the tip should be recorded. […] If the penis does not achieve full erection during the test, then the physician has also documented associated ED, and the recommended treatment can be appropriately adjusted to address both problems.

• #60 Peyronie Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560628/

  The most critical components of the evaluation are the patient’s history and a thorough physical examination. There is no mandatory or necessary laboratory or imaging testing to complete a Peyronie disease workup. […] The American Urological Association (AUA), Canadian Urological Association (CUA), and the European Association of Urology (EAU) guidelines recommend performing an in-office intracavernous injection (ICI) test with or without penile Doppler duplex ultrasound before any invasive intervention. […] Clinicians should assess and treat men with Peyronie disease only when they have the experience and diagnostic tools to evaluate, appropriately counsel, and treat the condition. […] The patient’s distress over his symptoms, level of concern, and willingness to undergo various types of treatment should be fully considered in the decision-making process, in addition to any objective measures of curvature and erectile function. […] Surgery is the durable and effective treatment for symptomatic Peyronie disease, particularly when severe enough to prevent intercourse and where less invasive therapies have failed.

• #61 Peyronie’s Disease Diagnosis: Understanding the Process and the Importance of Early Detection – Lakeview Center for Urology

  https://lakeviewurology.com/peyronies-disease-diagnosis/

  The diagnosis of Peyronies Disease is a multi-step process that involves taking a thorough medical history, conducting a physical examination, and using imaging tests to assess the extent and severity of the condition. […] Early diagnosis is key to preventing the progression of the disease and identifying the most appropriate treatment options.

• #62 Peyronie’s Disease Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/peyronies-disease-guideline

  1. The purpose of this guideline is to provide a clinical framework for the diagnosis and treatment of Peyronie’s disease (PD). […] 2. Clinicians should engage in a diagnostic process to document the signs and symptoms that characterize Peyronie’s disease. The minimum requirements for this examination are a careful history (to assess penile deformity, interference with intercourse, penile pain, and/or distress) and a physical exam of the genitalia (to assess for palpable abnormalities of the penis). (Clinical Principle) […] 3. Clinicians should perform an in-office intracavernosal injection (ICI) test with or without duplex Doppler ultrasound prior to invasive intervention. (Expert Opinion) […] 4. Clinicians should evaluate and treat a man with Peyronie’s disease only when he/she has the experience and diagnostic tools to appropriately evaluate, counsel, and treat the condition. (Expert Opinion)

• #63

  https://journals.lww.com/co-urology/fulltext/2020/05000/the_role_of_imaging_in_the_diagnosis_and.2.aspx

  Several imaging modalities exist for the assessment of Peyronie’s disease. However, comprehensive recommendations for using these objective modalities based on large-scale evidence-based studies do not yet exist. Our objective is to evaluate current imaging techniques and provide a model that we follow in our clinic in the workup and management of Peyronie’s disease. […] Ultrasonography is the preferred imaging modality in Peyronie’s disease and noninvasively characterizes penile plaques and monitors plaque response to various treatments. At our center, we perform ultrasonography with intracavernosal injection in all patients with Peyronie’s disease to evaluate the degree of curvature, plaque characteristics, and concomitant erectile dysfunction to better guide management decisions.

• #64 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Peyronies-Disease-Diagnosis.aspx

  This is followed by the evaluation of the penile curvature and plaques. […] Although the association between Peyronies disease and a plethora of histocompatibility antigens has been demonstrated (as well as with anti-DNA, antielastin and antinuclear antibodies), thus far none of them are being used as a specific marker for this disease. Therefore, the role of the laboratory in diagnosing this condition is negligible. […] However, imaging of penile shaft can be a noteworthy endeavor in the diagnosis of Peyronies disease, as it can assess the level of plaque calcification, as well as signify the terminal point of chronic stage of the disease where no further angulation can be seen. […] A much more cost-effective approach is high-resolution penile ultrasound, especially for calcified plaques, with the detection rate up to 95%.

• #65 Peyronie’s Disease Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/peyronies-disease-guideline

  1. The purpose of this guideline is to provide a clinical framework for the diagnosis and treatment of Peyronie’s disease (PD). […] 2. Clinicians should engage in a diagnostic process to document the signs and symptoms that characterize Peyronie’s disease. The minimum requirements for this examination are a careful history (to assess penile deformity, interference with intercourse, penile pain, and/or distress) and a physical exam of the genitalia (to assess for palpable abnormalities of the penis). (Clinical Principle) […] 3. Clinicians should perform an in-office intracavernosal injection (ICI) test with or without duplex Doppler ultrasound prior to invasive intervention. (Expert Opinion) […] 4. Clinicians should evaluate and treat a man with Peyronie’s disease only when he/she has the experience and diagnostic tools to appropriately evaluate, counsel, and treat the condition. (Expert Opinion)

• #66 Peyronie’s Disease Diagnosis: Understanding the Process and the Importance of Early Detection – Lakeview Center for Urology

  https://lakeviewurology.com/peyronies-disease-diagnosis/

  Understanding the patients medical history provides valuable insight into the likely causes and progression of Peyronies Disease, helping the doctor determine the best approach for further evaluation and treatment. […] After taking the medical history, the next step in the diagnostic process is a physical examination. […] In some cases, doctors may use imaging tests to further evaluate Peyronies Disease. […] The most commonly used imaging technique is ultrasound. […] Since Peyronies Disease can lead to erectile dysfunction, doctors may also assess erectile function as part of the diagnostic process. […] Accurate staging of the disease is crucial for determining the appropriate treatment plan. […] Understanding the stage of Peyronies Disease allows the doctor to tailor treatment options accordingly.

• #67 Peyronie’s Disease Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/peyronies-disease-guideline

  5. The clinician should engage in a diagnostic process to document the signs and symptoms that characterize Peyronie’s disease. The minimum requirements for this examination are a careful history (to assess penile deformity, interference with intercourse, penile pain, and/or distress) and a physical exam of the genitalia (to assess for palpable abnormalities of the penis). (Clinical Principle) […] 6. Clinicians should perform an in-office intracavernosal injection (ICI) test with or without duplex Doppler ultrasound prior to invasive intervention. (Expert Opinion) […] 7. Clinicians should evaluate and treat a man with Peyronie’s disease only when he/she has the experience and diagnostic tools to appropriately evaluate, counsel, and treat the condition. (Expert Opinion) […] 8. Clinicians should discuss with patients the available treatment options and the known benefits and risks/burdens associated with each treatment. (Clinical Principle)

• #68 Peyronie’s Disease Diagnosis: Understanding the Process and the Importance of Early Detection – Lakeview Center for Urology

  https://lakeviewurology.com/peyronies-disease-diagnosis/

  Peyronies Disease is a complex condition characterized by the development of fibrous scar tissue (plaque) inside the penis, leading to curvature, pain, and functional issues, particularly during erections. […] One of the most important aspects of managing Peyronies Disease is early diagnosis, which can help in identifying appropriate treatment options and potentially prevent the condition from worsening. […] Early diagnosis of Peyronies Disease is critical for several reasons: […] The stage at which Peyronies Disease is diagnosed can influence the available treatment options. […] Early diagnosis allows for more effective pain management strategies to be implemented, improving the patients quality of life. […] The first step in diagnosing Peyronies Disease is taking a detailed medical history.

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