C Muyshondt1, A Faix, P Costa, S Droupy. 1. Service d'urologie andrologie, CHU Carémeau-Nîmes, Place Pr.-Debré, 30029 Nîmes cedex 9, France. cmuyshondt@wanadoo.fr
Abstract
PURPOSE: Assessment of the Peyronie's disease (PD) is clinical in absence of validated questionnaire or of para-clinical standardized test. The international index of erectile function (IIEF) and Lue's score are used for the clinical evaluation. Penile dynamic duplex ultrasound (PDU) was considered in the 2010 recommendations as "useful but not necessary test". The objective of this study was to estimate the utility of the scores and of the PDU in the diagnostic and in the therapeutic decision at the patients suffering from a PD. PATIENTS: Twenty-one patients were included in this forward-looking single-center study over 12 months. All the patients had a clinical examination with photos, an evaluation using the IIEF-5 and the Lue's score and a PDU. RESULTS: The average age was of 57.7 years (34-77) with an average evolution duration of 38.9 months. IIEF-5 was not adapted to the assessment of the preoperative erectile function of the PD because the questions 3 to 5 were modified by the penil deformity. The result of Lue's score did not seem to us to have interest in the therapeutic decision because it is not recommended to operate a patient in evolution. Plaques were classified according to ultrasonographic patterns : presence of hyperechoic or/and calcified lesion. The application of relevant differential ultrasound criteria turned out delicate. The PDU found abnormalities of the vascular flows for 61.9 % of the patients. Nine patients were operated and PDU modified the surgical gesture for two of them. CONCLUSION: The search for objective criteria of evaluation of the PD is essential, but those currently proposed, clinical or ultrasound seemed to us a little adapted or difficult to apply.
PURPOSE: Assessment of the Peyronie's disease (PD) is clinical in absence of validated questionnaire or of para-clinical standardized test. The international index of erectile function (IIEF) and Lue's score are used for the clinical evaluation. Penile dynamic duplex ultrasound (PDU) was considered in the 2010 recommendations as "useful but not necessary test". The objective of this study was to estimate the utility of the scores and of the PDU in the diagnostic and in the therapeutic decision at the patients suffering from a PD. PATIENTS: Twenty-one patients were included in this forward-looking single-center study over 12 months. All the patients had a clinical examination with photos, an evaluation using the IIEF-5 and the Lue's score and a PDU. RESULTS: The average age was of 57.7 years (34-77) with an average evolution duration of 38.9 months. IIEF-5 was not adapted to the assessment of the preoperative erectile function of the PD because the questions 3 to 5 were modified by the penil deformity. The result of Lue's score did not seem to us to have interest in the therapeutic decision because it is not recommended to operate a patient in evolution. Plaques were classified according to ultrasonographic patterns : presence of hyperechoic or/and calcified lesion. The application of relevant differential ultrasound criteria turned out delicate. The PDU found abnormalities of the vascular flows for 61.9 % of the patients. Nine patients were operated and PDU modified the surgical gesture for two of them. CONCLUSION: The search for objective criteria of evaluation of the PD is essential, but those currently proposed, clinical or ultrasound seemed to us a little adapted or difficult to apply.