Introduction

1. No. 098 Penile duplex ultrasonography in men with Peyronie's disease: Veno-occlusive dysfunction or poor cavernosal arterial inflow; clinical insights to differentiate their contributions to ED. Eric Chung1,2, Ling De Young2 and Gerald B Brock2 1 Department of Urology, Princess Alexandra Hospital, Brisbane, QLD Australia 2 Division of Urology, St Joseph Health Care, London, ON Canada Introduction At least 20% of men with Peyronie's disease (PD) suffer from erectile dysfunction (ED). The fundamental mechanism is thought to arise from the progression of fibrosis limited to the PD plaque within the tunica albuginea. However recent studies have highlighted the possibility of fibrosis of the cavernosal vessel media wall leading to impairment of arterial inflow. • Results • A total of 1120 men underwent penile CDU during the 10 year period. • Complete information was obtained in 810 men with 250 men complained of decreased penile rigidity while 150 men were unable to sustain erection (Figure 1). • Co-morbidities were similar between PD men with and without ED. • Tunical thickening (65%) was the most common CDU feature and mean cumulative calcifications was 24.2mm2 (1 to 360 mm2, SD 76) (Table 1). • The peak systolic and end-diastolic velocities on the right cavernosal artery were 14.2 cm/s and 3.5 cm/s, while the left cavernosal artery measurements were 15.1 cm/s and 3.2 cm/s (Table 1). • Multivariate logistic regression model showed strong correlation between plaque size and development of ED. • Both CVOD and impaired cavernosal arterial inflow were associated with ED. • Aim • To evaluate penile color duplex ultrasonographic (CDU) findings in men with PD who have concomitant ED. • To determine whether cavernosal veno-occlusive dysfunction (CVOD) and/or impairment in cavernosal arterial inflow is the major cause of ED in men with PD. • Methods • A retrospective review of all men presenting with penile curvature and length loss who underwent penile CDU. • Study period between January 2001 and January 2010. • Patient demographic, co-morbidities, International Index of Erectile Function-5 (IIEF-5) scores, surgical intervention and physical findings were documented. • Penile curvature, plaque size, peak systolic and end-diastolic velocities on CDU were recorded. Table 1: Penile CDU findings in men with PD and ED (PSV-peak systolic velocity, EDV-end diastolic velocity) Chung E and Brock GB. Duplex sonographic study of impotent men with Peyronie’s disease: Is veno-occlusion the cause? J Sex Med 2011;8(12):3446-51 Figure 1: Presenting complaints in men with PD • Conclusions • Veno-occlusive dysfunction and impaired cavernosal arterial inflow contributed to the development of ED. • Larger plaque size is the best predictor of progression to surgical intervention. Poster presentation sponsor