When diagnosing Peyronie’s disease, there are a number of factors to consider, including the degree of curvature, the size and characteristics of plaques, the presence of pain, and the ability to have an erection suitable for intercourse.
However, there are few evidence-based guidelines for objectively assessing such traits, and such guidelines vary among researchers and medical organizations. For example, the American Urological Association suggests using intracavernosal injection to induce an erection for clinical evaluation. In contrast, the European Urological Association recommends the use of home photography to capture a natural erection for assessment.
Variations like these prompted researchers to review available options for evaluating Peyronie’s disease. The results were published in March in Sexual Medicine Reviews, with focus in four areas: deformity, plaque characteristics, inflammation, and erectile dysfunction (ED).
Monitoring curvature helps clinicians design treatment protocols and determine how well treatments are working. Some “novel techniques” for doing so, include the following:
- University of Washington Peyronie’s Examination Network (UWPEN). Patients can use this smartphone app to measure curvature and girth using at-home photography.
- 3-D photography. A proof-of-concept study used a set of 3D-printed models and an infrared camera to determine curvature and penile volume.
- iGrafter. This iPad app can make templates for grafts.
Clinicians use palpation and caliper measurement to learn more about penile plaques. However, imaging methods, such as ultrasound, magnetic resonance imaging (MRI), computer tomography, and radiography may be helpful as well, although the last two options involve radiation exposure that might not be necessary.
MRI and nuclear scintigraphy may be used to measure the amount of inflammation present around the plaques. However, there is little evidence showing that serum testing provides many clues about inflammation.
Erectile Dysfunction (ED)
ED can accompany Peyronie’s disease; it may also be a side effect of treatment. Color Doppler ultrasonography may help clinicians learn more about the causes of ED and penile vascularization in men with Peyronie’s disease.
All of these factors, together with penile length and degree of curvature, can create a clearer picture of Peyronie’s disease, the authors pointed out, adding that objective, standardized measurements are needed for research as well.
They called for further studies to focus on evidence-based objective assessments.
Sexual Medicine Reviews
Chen, Jessie Y., MD, et al.
“Objective Assessments of Peyronie’s Disease”
(Full-text. Published online: February 21, 2018)