📃 Paper Title: The natural history of Peyronie's disease: an ultrasonography-based study
🧍 Author: Bekos
🕒 Year: 2008
📚 Journal: European Urology
🌎 Country: Greece
ㅤContext to the study:
Can you tell me about a study that looked at the progression of Peyronie's disease using ultrasound?
ㅤ✅ Take-home message of study:
This paper aimed to understand the natural progression of Peyronie's disease using ultrasound imaging. Ultrasound was used to follow the progression of plaque size over time, and assess the impact of treatment on plaque size. The study found that the size and shape of plaques tend to remain stable over time, and do not progress to cause severe curvature or erectile dysfunction in most men. Solitary hyperechoic lesions without acoustic shadow had the highest rate (82%) of reduction in size and curvature.
ㅤ Prospective observational study
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Study participants:
95 men with Peyronie's disease included.
Inclusion criteria:
Adult men with a diagnosis of Peyronie's disease
Willingness to participate in the study and attend regular follow-up visits
Exclusion criteria:
Patients with Hx of penile fracture were excluded.
Colour Doppler performed on all patients for: Penile vascular assessment; Size of lesion; Location of lesion; Morphological patterns of lesion; Patients were categorised based on distinct ultrasonographic patterns.
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Key study outcomes:
Patients were classified into groups A (11.6%), B (36.8%), and C (51.6%); (solitary hyperechoic lesion without acoustic shadow (group A), moderately hyperechoic multiple scattered calcified lesions with acoustic shadows (group B), dense calcified hyperechoic plaque with acoustic shadow (group C)).
Group A: 9 of 11 (81.8%) experienced a reduction in fibrotic lesions and curvature angle, while 2 of 11 (18.2%) had plaque formation.
Group B: Plaque and curvature reduction was noticed in 15 of 35 (42.9%) patients, whereas in the rest, a dense calcified plaque was noticed. Curvature reduction occurred in 12 of 35 (34.3%) patients.
Group C: No ultrasonographic evidence of improvement was noticed; the curvature angle was reduced in 4 of 49 (8.2%) patients, owing to the extension of the plaque circumferentially.
Significant haemodynamic changes were noticed at the two time points tested: 30.53% were diagnosed with vascular disease at baseline versus 46.32% at the end of the study (p=0.03).
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Study Limitations:
Small sample size
Single-centre
Limited follow-up time (1 year)
Ultrasound imaging may not have captured all changes in Peyronie's disease
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