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Penile
Daniel Childers, MD; Mark E. Lockhart, MD, MPH
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Definitions

          • Erectile dysfunction (ED): Inability to achieve or maintain erection
            • Etiologies are numerous and can include psychologic, arterial, venous, neurogenic, or endocrinologic factors
          • Penile Doppler: Sonographic evaluation of common etiologies of ED after direct injection of prostaglandin mixture into corpora cavernosa
          • Peyronie disease (PD): Abnormal curvature of penis typically with associated plaque, oftentimes causing sexual dysfunction
            • Plaques often form on tunica albuginea or corpora cavernosa
              • Fibrosis can also occur in septum and within corpora itself
              • Vast majority of plaques occur on dorsal surface of penis
              • Nearly 1/2 of plaques occur in distal 1/3 of penis
            • Can cause painful erections
            • Can cause shortening of penis
            • Uncertain etiology with possibilities including repetitive microtrauma, collagen vascular disease, and advancing age
            • Very rarely spontaneously regresses

        IMAGING

        • General Features

          • Ultrasonographic Findings

            • MR Findings

              • Imaging Recommendations

                DIFFERENTIAL DIAGNOSIS

                  CLINICAL ISSUES

                  • Presentation

                    • Demographics

                      • Natural History & Prognosis

                        • Treatment

                          DIAGNOSTIC CHECKLIST

                          • Consider

                            • Image Interpretation Pearls

                              • Reporting Tips

                                Selected References

                                1. Gupta N et al: Penile Doppler ultrasound predicting cardiovascular disease in men with erectile dysfunction. Curr Urol Rep. 16(3):16, 2015
                                2. Chung E et al: Penile Doppler sonographic and clinical characteristics in Peyronie's disease and/or erectile dysfunction: an analysis of 1500 men with male sexual dysfunction. BJU Int. 110(8):1201-5, 2012
                                3. Kalokairinou K et al: US imaging in Peyronie's disease. J Clin Imaging Sci. 2:63, 2012
                                4. Patel DV et al: Investigation of erectile dysfunction. Br J Radiol. 85 Spec No 1:S69-78, 2012
                                5. Bertolotto M et al: Painful penile induration: imaging findings and management. Radiographics. 29(2):477-93, 2009
                                6. Halls J et al: Erectile dysfunction: the role of penile Doppler ultrasound in diagnosis. Abdom Imaging. 34(6):712-25, 2009
                                7. Prando D: New sonographic aspects of peyronie disease. J Ultrasound Med. 28(2):217-32, 2009
                                8. Hakim LS: Peyronie's disease: an update. The role of diagnostics. Int J Impot Res. 14(5):321-3, 2002
                                9. Kim SH: Doppler US evaluation of erectile dysfunction. Abdom Imaging. 27(5):578-87, 2002
                                10. Fitzgerald SW et al: Color Doppler sonography in the evaluation of erectile dysfunction. Radiographics. 12(1):3-17; discussion 18-9, 1992
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Imaging

                                    • Clinical Issues

                                      TERMINOLOGY

                                      • Definitions

                                        • Erectile dysfunction (ED): Inability to achieve or maintain erection
                                          • Etiologies are numerous and can include psychologic, arterial, venous, neurogenic, or endocrinologic factors
                                        • Penile Doppler: Sonographic evaluation of common etiologies of ED after direct injection of prostaglandin mixture into corpora cavernosa
                                        • Peyronie disease (PD): Abnormal curvature of penis typically with associated plaque, oftentimes causing sexual dysfunction
                                          • Plaques often form on tunica albuginea or corpora cavernosa
                                            • Fibrosis can also occur in septum and within corpora itself
                                            • Vast majority of plaques occur on dorsal surface of penis
                                            • Nearly 1/2 of plaques occur in distal 1/3 of penis
                                          • Can cause painful erections
                                          • Can cause shortening of penis
                                          • Uncertain etiology with possibilities including repetitive microtrauma, collagen vascular disease, and advancing age
                                          • Very rarely spontaneously regresses

                                      IMAGING

                                      • General Features

                                        • Ultrasonographic Findings

                                          • MR Findings

                                            • Imaging Recommendations

                                              DIFFERENTIAL DIAGNOSIS

                                                CLINICAL ISSUES

                                                • Presentation

                                                  • Demographics

                                                    • Natural History & Prognosis

                                                      • Treatment

                                                        DIAGNOSTIC CHECKLIST

                                                        • Consider

                                                          • Image Interpretation Pearls

                                                            • Reporting Tips

                                                              Selected References

                                                              1. Gupta N et al: Penile Doppler ultrasound predicting cardiovascular disease in men with erectile dysfunction. Curr Urol Rep. 16(3):16, 2015
                                                              2. Chung E et al: Penile Doppler sonographic and clinical characteristics in Peyronie's disease and/or erectile dysfunction: an analysis of 1500 men with male sexual dysfunction. BJU Int. 110(8):1201-5, 2012
                                                              3. Kalokairinou K et al: US imaging in Peyronie's disease. J Clin Imaging Sci. 2:63, 2012
                                                              4. Patel DV et al: Investigation of erectile dysfunction. Br J Radiol. 85 Spec No 1:S69-78, 2012
                                                              5. Bertolotto M et al: Painful penile induration: imaging findings and management. Radiographics. 29(2):477-93, 2009
                                                              6. Halls J et al: Erectile dysfunction: the role of penile Doppler ultrasound in diagnosis. Abdom Imaging. 34(6):712-25, 2009
                                                              7. Prando D: New sonographic aspects of peyronie disease. J Ultrasound Med. 28(2):217-32, 2009
                                                              8. Hakim LS: Peyronie's disease: an update. The role of diagnostics. Int J Impot Res. 14(5):321-3, 2002
                                                              9. Kim SH: Doppler US evaluation of erectile dysfunction. Abdom Imaging. 27(5):578-87, 2002
                                                              10. Fitzgerald SW et al: Color Doppler sonography in the evaluation of erectile dysfunction. Radiographics. 12(1):3-17; discussion 18-9, 1992