Bertini Alessandro, Pozzi Edoardo, Belladelli Federico, Raffo Massimiliano, Corsini Christian, Negri Fausto, Musso Giacomo, Cattafi Francesco, Ramadani Riccardo, Candela Luigi, Arma Alessia d', Montorsi Francesco, Salonia Andrea
Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.
Department of Urology, Vita-Salute San Raffaele University, Milan, Italy.
Andrology. 2024 Sep 30. doi: 10.1111/andr.13771.
There is inconsistent data regarding the possible inaccuracies in dynamic penile color Doppler duplex ultrasound (CDDU) measurements in men with penile curvature because of Peyronie's disease (PD). We sought to explore the relationship between the degree of penile curvature and CDDU parameters in men with PD.
Comprehensive data from 154 consecutive men presenting with PD as their primary complaint at a single academic center were prospectively collected and analyzed. All men underwent CDDU. Penile curvature was measured using a goniometer at time of maximum erection during CDDU. Patients were grouped based on CDDU parameters into-normal (average peak systolic velocity [PSV] ≥ 35 cm/s and resistance index [RI] ≥ 0.85) and pathological CDDU (average PSV < 35 cm/s and/or RI < 0.85). Descriptive statistics was used to compare the two subcohorts. Linear regression models were fitted to explore the association between the degree of penile curvature and dynamic CDDU parameters.
Overall, the median interquartile range (IQR) age was 56 (48-63) years. The median (IQR) PSV and degree of penile curvature were 48.8 cm/s (37.9-58.5) and 40 degrees (30-60), respectively. At CDDU, the degrees of penile curvature were as follows: 10-30 degrees in 63 (40.9%) men, 30-70 degrees in 70 (45.5%) men, and 70-90 degrees in 21 (13.6%) men, respectively. Of all, 116 (75.3%) patients showed a PSV > 35 cm/s and RI ≥ 0.85. Patients with pathologic vs. normal CDDU parameters did not differ in median (IQR) curvature (32.5° [30°-58.7°] vs. 40° [30°-65°], p = 0.5) or in the distribution across curvature range groups. Linear regression analysis revealed that the degree of penile curvature did not significantly correlate with PSV at CDDU (coefficient: 0.06, p = 0.3).
Our study confirms the lack of a significant correlation between the severity of penile curvature and CDDU parameters in men presenting with PD. These findings emerge to be relevant in terms of a more accurate management work-up for PD patients and hold insightful medicolegal implications and in the real-life setting.
关于佩罗尼氏病(PD)导致阴茎弯曲的男性患者动态阴茎彩色多普勒双功能超声(CDDU)测量可能存在的不准确数据并不一致。我们试图探讨PD男性患者阴茎弯曲程度与CDDU参数之间的关系。
前瞻性收集并分析了在单一学术中心以PD为主要诉求的154例连续男性患者的综合数据。所有男性均接受了CDDU检查。在CDDU检查期间阴茎最大勃起时使用角度计测量阴茎弯曲度。根据CDDU参数将患者分为正常组(平均收缩期峰值流速[PSV]≥35cm/s且阻力指数[RI]≥0.85)和病理性CDDU组(平均PSV<35cm/s和/或RI<0.85)。使用描述性统计方法比较这两个亚组。采用线性回归模型探讨阴茎弯曲程度与动态CDDU参数之间的关联。
总体而言,年龄的中位数四分位间距(IQR)为56(48 - 63)岁。PSV的中位数(IQR)和阴茎弯曲度分别为48.8cm/s(37.9 - 58.5)和40度(30 - 60)。在CDDU检查时,阴茎弯曲度如下:63例(40.9%)男性为10 - 30度,70例(45.5%)男性为30 - 70度,21例(13.6%)男性为70 - 90度。其中,116例(75.3%)患者的PSV>35cm/s且RI≥0.85。病理性与正常CDDU参数的患者在中位数(IQR)弯曲度(32.5°[30° - 58.7°]对40°[30° - 65°],p = 0.5)或弯曲度范围组的分布上无差异。线性回归分析显示,CDDU检查时阴茎弯曲度与PSV无显著相关性(系数:0.06,p = 0.3)。
我们的研究证实,在患有PD的男性中,阴茎弯曲严重程度与CDDU参数之间缺乏显著相关性。这些发现对于PD患者更准确的管理评估具有重要意义,并在现实生活中有深刻的法医学意义。