Department of Urology, University of California San Francisco, California 94143-1695, USA.
J Urol. 2010 Apr;183(4):1484-8. doi: 10.1016/j.juro.2009.12.026. Epub 2010 Feb 20.
Traditionally, diagnosis and treatment plans for Peyronie's disease have been based on history and physical examination. Penile ultrasound provides rapid, anatomical information to establish disease severity, and to monitor progression and response to medical therapy. We determined the relationship between ultrasound characteristics and progression to surgical intervention in men with Peyronie's disease.
We conducted a retrospective cohort study of 518 patients with Peyronie's disease. Patients completed a Peyronie's disease specific questionnaire detailing medical history, health related behaviors and Peyronie's disease characteristics, and underwent sonographic evaluation of the penis. Measurements of subtunical calcifications, septal fibrosis, tunical thickening (tunica thickness greater than 2 mm) and intracavernous fibrosis were made. Progression to surgery was determined from the medical record.
In this cohort (mean patient age 53.8 years, range 20 to 78) 31% of patients had calcifications, 50% had tunical thickening, 20% had septal fibrosis and 15% had intracavernous fibrosis. Overall 25% of the cohort progressed to surgical intervention after an average followup of 1.25 years (range 0 to 7.6). Patients who underwent surgery were more likely to have subtunical calcifications present at the first clinic visit (OR 1.75, 95% CI 1.16-2.62). No other sonographic characteristics were associated with progression to surgery. After adjustment for age, marital status, degree of curvature, additional penile deformity, difficulty with penetration, ability to have intercourse and prior treatment for Peyronie's disease, calcifications were strongly associated with progression to surgery (OR 2.75, 95% CI 1.25-3.45).
In a large cohort of patients with Peyronie's disease the presence of sonographically detected sub-tunical calcifications during the initial office evaluation was independently associated with subsequent surgical intervention.
传统上，对 Peyronie 病的诊断和治疗计划基于病史和体格检查。阴茎超声可快速提供解剖学信息，以确定疾病的严重程度，并监测进展和对药物治疗的反应。我们确定了患有 Peyronie 病的男性中超声特征与手术干预进展之间的关系。
我们对 518 例 Peyronie 病患者进行了回顾性队列研究。患者完成了一份详细描述病史、健康相关行为和 Peyronie 病特征的 Peyronie 病特定问卷，并接受了阴茎超声评估。测量了皮下钙化、隔纤维化、 厚壁（壁厚大于 2 毫米）和海绵内纤维化。从病历中确定手术进展情况。
在该队列中（平均患者年龄 53.8 岁，范围 20 至 78 岁），31%的患者有钙化，50%的患者有厚壁，20%的患者有隔纤维化，15%的患者有海绵内纤维化。总体而言，在平均随访 1.25 年后（范围 0 至 7.6 年），25%的患者进展为手术干预。在首次就诊时就存在皮下钙化的患者更有可能接受手术（OR 1.75，95%CI 1.16-2.62）。其他超声特征与手术进展无关。在调整年龄、婚姻状况、弯曲程度、其他阴茎畸形、性交困难、性交能力和 Peyronie 病的既往治疗后，钙化与手术进展密切相关（OR 2.75，95%CI 1.25-3.45）。
在大型 Peyronie 病患者队列中，在最初的就诊时超声检查发现皮下钙化与随后的手术干预独立相关。
