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Measurement of Penile Curvature in Peyronie’s Disease Patients: Comparison of Three Methods

Published on Jan 1, 2007in The Journal of Sexual Medicine3.649
· DOI :10.1111/j.1743-6109.2006.00404.x
Michael Ohebshalom9
Estimated H-index: 9
(Cornell University),
John P. Mulhall62
Estimated H-index: 62
(Cornell University)
+ 1 AuthorsMarilyn Parker21
Estimated H-index: 21
(Loyola University Medical Center)
Abstract
ABSTRACT Aim Peyronie’s disease (PD) may be treated in a medical or surgical fashion. Factors involved in the decision of which treatment to choose include duration of disease and magnitude of penile deformity. Curvature can be measured using at‐home photography (AHP), vacuum erection device (VED), or intracavernosal injection (ICI). This study was undertaken to determine the concordance between the three methods of deformity assessment. Patients were also questioned regarding the presence of erectile dysfunction (ED) based on self‐report and the International Index of Erectile Function. Materials and Methods A total of 68 men presented to their urologist after taking penile photographs from three angles during maximal erectile rigidity. In the office, a VED was used to induce erection, and a goniometer was utilized to measure degree of curvature. ICI with trimix was then used to induce artificial erection, which was measured with a goniometer as well. Results There was a statistically significant difference in self‐report curvature magnitude compared with measured ICI‐assisted curvature. Curvature profiles included dorsal plaques in 50 patients (73.5%), ventral plaques in 10 (15%), and lateral in eight (11%). Using ICI, the mean curvature measured was 42 degrees. Mean degree of curvature using VED was 33 degrees, while that of photography was 34 degrees. Photographic measurements differed most from ICI in men with concurrent ED ( P 60 degrees. Conclusions Our results show that the degree of curvature measured using vacuum‐assisted device and AHP is underestimated as compared with the gold standard ICI. We therefore recommend that ICI be used to most accurately determine degree of deformity. If ICI is not available, it is imperative that the same manner of measurement be used between all patients in a study group, as well as during serial evaluation in a trial. Ohebshalom M, Mulhall J, Guhring P, and Parker M. Measurement of penile curvature in Peyronie’s disease patients: Comparison of three methods. J Sex Med 2007;4:199–203.
  • References (12)
  • Citations (63)
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References12
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#1John P. Mulhall (Cornell University)H-Index: 62
#2Matthew Anderson (Loyola University Medical Center)H-Index: 5
Last. Marilyn Parker (Loyola University Medical Center)H-Index: 21
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ABSTRACT Introduction Men with Peyronie's disease who also have erectile dysfunction represent a challenge to the urologist. Historically, penile prosthesis surgery has been the management strategy of choice for this population. This study was undertaken to define the outcomes of a penile reconstructive surgery algorithm in men with Peyronie's disease and concomitant erectile dysfunction (ED). Methods Patients presenting with combined Peyronie's disease and erectile dysfunction were treated with...
90 CitationsSource
#1Ekkehard W. Hauck (University of Giessen)H-Index: 18
#2Ulrich O. Mueller (University of Giessen)H-Index: 1
Last. Wolfgang Weidner (University of Giessen)H-Index: 55
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ABSTRACTPurpose: Extracorporeal shock wave therapy (ESWT) for the treatment of Peyronie's disease is still controversial. This exploratory meta-analysis of published studies in the international literature investigates its therapeutic effects.Materials and Methods: The treatment outcomes from 17 study groups identified by a computerized literature search were compared with natural history outcomes and data from control groups from 2 controlled ESWT studies. An exploratory meta-analysis was perfo...
80 CitationsSource
#1Laurence A. Levine (Rush Medical College)H-Index: 51
#2J M Greenfield (Rush Medical College)H-Index: 1
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#1Ates Kadioglu (Istanbul University)H-Index: 33
#2Ahmet Tefekli (Istanbul University)H-Index: 30
Last. Tellaloğlu S (Istanbul University)H-Index: 12
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ABSTRACTPurpose: We discuss the clinical appearance and natural outcome of Peyronie’s disease.Materials and Methods: During an 8-year period 307 men with Peyronie’s disease were evaluated, and clinical characteristics, risk (factors), penile deformities, erectile status and outcome were analyzed.Results: Mean patient age plus or minus standard deviation was 52.8 ± 9.3 years (range 23 to 76). Penile deformity, pain on erection and palpable nodule were the most common (85%) presenting symptoms, us...
185 CitationsSource
#1Wayne J.G. Hellstrom (Tulane University)H-Index: 63
#2Trinity J. Bivalacqua (Tulane University)H-Index: 48
Since the first clinical series on penile curvature was reported in 1743 by Francois Gigot de la Peyronie, the etiology and mechanism of this well-recognized symptom complex has remained undetermined. Peyronie’s disease is a localized connective tissue disorder characterized by changes in the collagen composition of the tunica albuginea of the penis. The end result is a fibrous plaque that contains an excessive amount of collagen, alterations in the elastin framework, and fibroblastic proliferat...
135 CitationsSource
#1Ahmed I. El-Sakka (SFVAMC: San Francisco VA Medical Center)H-Index: 27
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AbstractPurpose: Increased TGF-beta 1 protein expression in tunica albuginea has been found to be associated with Peyronie's disease. The present study is designed to investigate whether surgical trauma induces TGF-beta up-regulation and histological changes in rat penis.Materials and Methods: Thirty-two adult male Sprague-Dawley rats were divided into two groups. The first group (n = 24) underwent incision and suture repair of the tunica albuginea of the penis. The second group (n = 8) received...
55 CitationsSource
#1Laurence A. Levine (Rush University Medical Center)H-Index: 51
#2Eric L. Lenting (Rush University Medical Center)H-Index: 1
AbstractPurpose: When conservative treatment of Peyronie's disease fails, the optimal surgical approach is not well defined. Multiple factors, including penile rigidity, degree of curvature, shaft narrowing with hinge effect and erectile response to vasoactive penile injections, indicate that no single approach is likely to solve the problem in all patients.Materials and Methods: A surgical algorithm was developed for the treatment of Peyronie's Disease based on our previous surgical experience,...
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#1Jonathan P. Jarow (Wake Forest University)H-Index: 30
#2Franklin C. Lowe (Wake Forest University)H-Index: 1
ABSTRACTPurpose: It has been postulated that trauma to either the partially or fully erect penis is a potential cause of Peyronie's disease. In addition, it has been proposed that engaging in sexual relations with a partial erection due to mild impotence is a risk factor for the development of Peyronie's disease. This study was performed to determine whether patients with either Peyronie's disease or non-Peyronie's disease impotence had an increased rate of penile trauma compared with potent con...
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#2Geng-Long Hsu (UCSF: University of California, San Francisco)H-Index: 18
Last. Tom F. Lue (UCSF: University of California, San Francisco)H-Index: 82
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ABSTRACTPurpose: We studied the fine architecture of the tunica albuginea of the penis.Materials and Methods: The study included 6 human male cadavers and 10 surgical patients (5 with Peyronie's disease and 5 with normal penile anatomy).Results: The tunica albuginea of the corpora cavernosa is a bi-layered structure with multiplelayers. Inner layer bundles support and contain the cavernous tissue and are oriented circularly. Radiating from this layer are intracavernous pillars acting as struts, ...
165 CitationsSource
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ABSTRACTPurpose: We obtained an objective evaluation of erectile function in patients with Peyronie's disease.Materials and Methods: Sexual dysfunction was analyzed in 222 patients with Peyronie's disease without previous local plaque therapy using a standardized protocol.Results: Of the 222 patients 70 (31.5%) complained of not being able to perform intercourse. In 4 men (1.8%) standardized diagnostic procedure demonstrated only a severe angulation making coitus impossible, and in 3 men (1.4%) ...
96 CitationsSource
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Peyronie's disease is a common yet poorly understood condition characterized by penile pain, curvature, sexual dysfunction and psychological bother. Peyronie's disease represents a penile wound healing disorder, and is thought to arise from exuberant scarring in response to penile trauma in genetically predisposed men. In the absence of active treatment, the majority of men experience stable or worsening symptoms, with few reporting spontaneous resolution in penile curvature or other deformity. ...
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