Introduction & Objectives
Peyronie's disease is characterized by formation of hardened scar and fibrous tissue in the tunica albuginea, septum and corpora cavernosa of the penis. Its typical symptoms are the painful bend during erection, which makes sexual intercourse difficult and palpable plaque or tough "cord" on the dorsal side of the penis. Proper evaluation of the plaque's location and size is important in the choice of treatment method and in the evaluation of the effects of instituted treatment.
3D ultrasound transducers enable to obtain three-dimensional images and make the evaluation of the examined organ more accurate.
The aim of this study was to present the examination methods, indications and advantages of three-dimensional ultrasound in the diagnosis of induratio penis plastica (Peironie' s disease) and assessment of the effects of treatment.
Material & Methods
3D ultrasound scanning was performed in twelve patients with Peyronie's disease with palpable plaques in the tunica albuginea of the penis. The scanning was carried out with a linear transducer (ultrasonic wave frequency of 12 MHz) positioned transversely to the long axis of the penis and then moved from the root of the penis towards the glans penis. During movement of the transducer, single ultrasound images are obtained and arranged to give an appearance of a three-dimensional image.
We obtained the ultrasound images, encoded as "volumetric units", or voxels, and arranged to form a cube, which was later computer-processed, using a specially designed computer program. In addition to traditional longitudinal and transverse views, it enabled to obtain also a coronal view. In patients with Peyronie's disease, this third view is of great importance since it allows for visualization of the whole plaque. Careful image analysis performed after the examination (not in the patient's presence) allowed to identify other, smaller plaques which were not observed prior to examination.
l. 3D ultrasound diagnosis allows for more accurate evaluation of pathologic changes in the tunica albuginea of the penis in Peyronie's disease.
2. Final evaluation involving analysis of obtained images is done after the examination and not in the patient's presence.
3. Examination time is shortened when compared with two-dimensional ultrasound.