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Testosterone Replacement, Low T, HCG, & Beyond
When Testosterone Is Not Enough
The use of ultrasonography in the evaluation and management of peyronie’s disease
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<blockquote data-quote="madman" data-source="post: 183385" data-attributes="member: 13851"><p><strong>Objective:</strong> <em><span style="color: rgb(184, 49, 47)">To outline the steps in the ultrasonographic evaluation of Peyronie’s disease and determine its use in the diagnosis, classification, and treatment of this disorder.</span></em></p><p></p><p><strong>Design:</strong> Video presentation</p><p></p><p><strong>Setting:</strong> Outpatient Urology clinic.</p><p></p><p><strong>Patient(s):</strong> All patients with Peyronie’s disease undergoing penile ultrasonography who signed written, informed consent for the video and audio recording.</p><p></p><p><strong>Intervention(s): </strong>Alprostadil + papaverine + phentolamine intracavernosal injections, penile ultrasonography, phenylephrine intracavernosal injections.</p><p></p><p><strong>Main Outcome Measure(s):</strong> Penile plaque classification, penile blood flow and degree of penile curvature</p><p></p><p><strong>Result(s):</strong> <em><span style="color: rgb(184, 49, 47)">During the period November 2018-December 2019, 156 patients were evaluated for Peyronie’s disease using ultrasonography, <strong>from which 109 patients presented calcified plaques. Out of these, 59 (45.1%) patients were found to have type 2 plaques, making this one the most common type of plaque.</strong> The average age in this group of patients was 59.8 ± 6.0 years, the average degree of curvature was 49.4 ± 23.0°, and the average duration of symptoms was 27.2 ± 36.9 months. During the vascular evaluation with Doppler ultrasonography, 23 (14.7%) patients presented PSV 25 < 30 cm3/s. The degree of curvature was not found to be associated with the severity of calcification (p = 0.17).</span></em> <span style="color: rgb(44, 130, 201)"><em><strong>This video demonstrates the advantages that ultrasonography provides in the evaluation and management of Peyronie’s disease compared to other imaging modalities. It avoids radiation, easily detects plaques and calcification and is more familiar to urologists. </strong>We outline the steps of the procedure; the possible findings during the penile tissue evaluation; the different types, location and size of plaques; the direction of penile curvature and deformity, and the possible findings on Doppler ultrasonography, which can further guide the management of these patients Figs. 1–4, Tables 1–4.</em></span></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p><strong>Conclusion </strong></p><p></p><p>• <em><strong><span style="color: rgb(184, 49, 47)">Penile Doppler ultrasound is a useful tool in the evaluation and management of Peyronie’s disease. </span></strong></em></p><p></p><p>•<em><span style="color: rgb(184, 49, 47)"><strong> Understanding the type of calcification and degree of curvature can aid to decide the management of Peyronie’s disease. </strong></span></em></p></blockquote><p></p>
[QUOTE="madman, post: 183385, member: 13851"] [B]Objective:[/B] [I][COLOR=rgb(184, 49, 47)]To outline the steps in the ultrasonographic evaluation of Peyronie’s disease and determine its use in the diagnosis, classification, and treatment of this disorder.[/COLOR][/I] [B]Design:[/B] Video presentation [B]Setting:[/B] Outpatient Urology clinic. [B]Patient(s):[/B] All patients with Peyronie’s disease undergoing penile ultrasonography who signed written, informed consent for the video and audio recording. [B]Intervention(s): [/B]Alprostadil + papaverine + phentolamine intracavernosal injections, penile ultrasonography, phenylephrine intracavernosal injections. [B]Main Outcome Measure(s):[/B] Penile plaque classification, penile blood flow and degree of penile curvature [B]Result(s):[/B] [I][COLOR=rgb(184, 49, 47)]During the period November 2018-December 2019, 156 patients were evaluated for Peyronie’s disease using ultrasonography, [B]from which 109 patients presented calcified plaques. Out of these, 59 (45.1%) patients were found to have type 2 plaques, making this one the most common type of plaque.[/B] The average age in this group of patients was 59.8 ± 6.0 years, the average degree of curvature was 49.4 ± 23.0°, and the average duration of symptoms was 27.2 ± 36.9 months. During the vascular evaluation with Doppler ultrasonography, 23 (14.7%) patients presented PSV 25 < 30 cm3/s. The degree of curvature was not found to be associated with the severity of calcification (p = 0.17).[/COLOR][/I] [COLOR=rgb(44, 130, 201)][I][B]This video demonstrates the advantages that ultrasonography provides in the evaluation and management of Peyronie’s disease compared to other imaging modalities. It avoids radiation, easily detects plaques and calcification and is more familiar to urologists. [/B]We outline the steps of the procedure; the possible findings during the penile tissue evaluation; the different types, location and size of plaques; the direction of penile curvature and deformity, and the possible findings on Doppler ultrasonography, which can further guide the management of these patients Figs. 1–4, Tables 1–4.[/I][/COLOR] [B]Conclusion [/B] • [I][B][COLOR=rgb(184, 49, 47)]Penile Doppler ultrasound is a useful tool in the evaluation and management of Peyronie’s disease. [/COLOR][/B][/I] •[I][COLOR=rgb(184, 49, 47)][B] Understanding the type of calcification and degree of curvature can aid to decide the management of Peyronie’s disease. [/B][/COLOR][/I] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
When Testosterone Is Not Enough
The use of ultrasonography in the evaluation and management of peyronie’s disease
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