The Effectiveness of 3-D Computed Tomography in the Evaluation of Penile Deformities in Patients With Peyronie's Disease: A Pilot Study

Sex Med. 2019 Sep;7(3):311-317. doi: 10.1016/j.esxm.2019.06.009. Epub 2019 Jul 16.

Abstract

Background: Anatomic and functional evaluation of the penis before treatment is very important in the choice of treatment in patients with Peyronie's disease (PD).

Aim: To compare 3 different methods for the evaluation of the penile deformity, including auto-photography, combined intracavernous injection stimulation test (CIS), and 3-dimensional computed tomography (3D CT) during artificial penile erection in patients with PD.

Methods: Pretreatment penile deformities of patients with PD were compared with those detected with auto-photography, using goniometer after intracavernosal vasoactive agent, and 3D CT correlations among these 3 methods were investigated.

Main outcome measures: Assessments of penile curvature with auto-photography, CIS, and 3D CT.

Results: The mean age of 36 patients who were included in the study was 58 ± 8.25 (36-72) years, and the mean time since the onset of the disease was 25 ± 24 months (2-144). Degrees of penile curvatures measured using auto-photography, CIS, and CT were determined as 24° (0°-80°), 40° (0°-90°), and 34° (0°-80°), respectively. When general correlation analysis was performed to evaluate the penile curvatures of all patients using 3 methods, a moderate correlation between auto-photography and both CIS (r = 0.72, P < .001) and 3D CT (r = 0.56, P < .001) was detected, whereas a strong correlation was noticed between CIS and 3D CT (r = 0.78, P < .001). When the correlation analysis between patients with and without ED was examined, a statistically significant decrease in the strength of correlation between CIS and auto-photography in patients with ED (0.629 vs 0.925, P < .05), however, was detected without any statistically significant difference in patients without ED (0.694 vs 0.813, P > .05).

Conclusion: The superiority of 3D CT over auto-photography and its strong correlation with CIS in most parameters have been demonstrated. However, it was found that CT did not give more information than the evaluation with CIS. Current limitations and cost increases limit the use of 3D CT in the assessment of PD. Özmez A, Ortac M, Cevik G, et al. The Effectiveness of 3-D Computed Tomography in the Evaluation of Penile Deformities in Patients With Peyronie's Disease: A Pilot Study. Sex Med 2019;7:311-317.

Keywords: Deformity; Penile Curvature; Peyronie's Disease.