ObjectiveTo analyze the MRI manifestations of Peyronie's disease and investigate the value of high-field MRI in the diagnosis of the disease.

METHODSUsing a small surface coil, we performed 3.0 Tesla MRI for 14 patients with clinically diagnosed Peyronie's disease. The MRI protocol included routine sequences (T1WI, T2WI, and enhanced T1WI) and susceptibility-weighted imaging (SWI). Each patient had received 2－4 penile ultrasound examinations previously. We compared the MRI findings with the results of ultrasonography.

RESULTSMRI manifested 25 penile plaques in the 14 patients, 3 (7 plaques) with inflammation, 4 (8 plaques) with fibrosis, and the other 7 (10 plaques) with calcification displaying a low signal intensity on SWI. Ultrasonography had revealed the 10 calcified plaques in all the 20 examinations, but exhibited the 7 inflammatory and 8 fibrotic ones in only 3 of the 23 examinations. The combination of MRI SWI sequences was necessitated for the detection of calcified plaques and achieved higher detection rates than ultrasonography for inflammatory and fibrotic plaques (P<0.05).

CONCLUSIONSHigh-field MRI has high sensitivity and accuracy in the diagnosis of Peyronie's disease, which can effectively display penile plaques of different nature in the early stage through multi-parametric sequences.

Calcinosis ; diagnostic imaging ; Fibrosis ; Humans ; Magnetic Resonance Imaging ; instrumentation ; methods ; Male ; Penile Induration ; diagnostic imaging ; Penis ; diagnostic imaging ; pathology ; Sensitivity and Specificity ; Ultrasonography

OBJECTIVETo evaluate the 5-item version of the international index of erectile function (IIEF-5) as a method to differentiate the causes of vasculogenic erectile dysfunction (ED).

METHODSIn all, 103 ED patients (mean age 46.8 +/- 18.7) were reviewed by IIEF-5. Penile blood flow was also assessed in each patient after an intracavernosal injection (ICI) and audio-visual sex stimulation by duplex Doppler ultrasonography. The 99mTc-(113m)In dual radioisotope test was performed to confirm specific vascular causes in the vasculogenic ED cases. Kruskal-Wallis TEST was employed to compare the scores of IIEF-5 with the results of ICI, duplex Doppler ultrasonography and the 99mTC-(113m)In dual radioisotope test.

RESULTSOf the total number of ED cases, 37 (37/103, 35.9%) were nonvasculogenic, 18 (18/103, 17.5%) arteriogenic, 35 (35/103, 34.0%) venogenic and 13 (13/103, 12.6%) combined vasculogenic. There was no significant difference in the IIEF-5 scores either between the vasculogenic group and the non-vasculogenic one (P = 0.253) or among different groups of the vasculogenic ED patients.

CONCLUSIONIIEF-5 cannot be used as a tool for differential diagnosis of vasculogenic ED, or to compare its specific vascular causes, nor can the scores of IIEF-5 reflect penile vascular conditions.

Adult ; Humans ; Impotence, Vasculogenic ; diagnosis ; diagnostic imaging ; Male ; Middle Aged ; Penis ; diagnostic imaging ; Smoking ; Surveys and Questionnaires ; Ultrasonography

OBJECTIVETo evaluate the relationship between the deformation of penile artery and the primary artery erectile dysfunction, and to improve the treatment and diagnosis of primary artery erectile dysfunction.

METHODSOne case of primary artery erectile dysfunction was presented with its primary clinic data.

RESULTSThe dorsal artery of the penis was thin and the bilateral penile arteries were lacking by arteriography. The implantation of a penile prosthesis significantly improved the patient's erectile function.

CONCLUSIONThe primary artery erectile dysfunction is a relatively rare disease. The possibility of primary artery erectile dysfunction should be kept in mind. Penile prosthesis implantation is an effective means for the treatment of primary artery erectile dysfunction.

Adult ; Arteries ; abnormalities ; Humans ; Impotence, Vasculogenic ; diagnostic imaging ; physiopathology ; surgery ; Male ; Penile Implantation ; Penis ; blood supply ; diagnostic imaging ; Radiography

Objective: To investigate the effect and safety of contrast-enhanced ultrasonography (CEUS) in the diagnosis of venous erectile dysfunction (VED). METHODS: From June 2015 to March 2016, 43 ED patients underwent corpus cavernography, of whom 23 were diagnosed with and the other 20 without corpus cavernosal venous leakage (CCVL). All the patients received intracorporal injection of a vasoactive drug and CEUS. RESULTS: Of the 23 patients with CCVL, 21 were confirmed by CEUS, including 12 cases of double venous leakage, 2 cases of single venous leakage, 5 cases of crural venous leakage, and 2 cases of the mixed type, while the other 2 showed no CCVL on CEUS. Of the 20 patients with CCVL, 2 presented CCVL on CEUS. CONCLUSIONS CEUS has the advantages of accuracy, safety, and less invasiveness in the diagnosis of VED.
Contrast Media ; Humans ; Impotence, Vasculogenic ; diagnostic imaging ; Injections ; Male ; Penis ; blood supply ; diagnostic imaging ; Ultrasonography ; methods ; Veins

Penile disease is one of the male urological diseases. Although the penis is a small organ, once the problem occurs, it often brings great trouble to the patient. Therefore, the accurate diagnosis of penile disease is particularly important. High-frequency ultrasonography, with its advantages of noninvasiveness, safety, low cost, easy operation and reproducibility, can clearly show the structure and blood flow of the penis and has a significant value in the diagnosis and follow-up of penile diseases such as vascular erectile dysfunction, priapism, penile injury, penile neoplastic and non neoplastic nodules. Meanwhile, the development of new technologies such as shear wave elastography (SWE) and contrast enhanced ultrasound (CEUS) has made up for the shortcomings of traditional ultrasound imaging, expanded the application of ultrasound in penile diseases, and improved the efficiency of ultrasound diagnosis of the diseases. This article focuses on the application value of ultrasound in erectile dysfunction, priapism, penile cavernous injury and penile tubercle, as well as the latest progress in such new technologies as SWE and CEUS applied to penile diseases.
Contrast Media ; Elasticity Imaging Techniques ; Erectile Dysfunction ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Penile Diseases ; diagnostic imaging ; Penile Neoplasms ; diagnostic imaging ; Penis ; diagnostic imaging ; injuries ; Priapism ; diagnostic imaging ; Reproducibility of Results ; Ultrasonography ; methods

Gadolinium ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Penile Neoplasms ; diagnosis ; diagnostic imaging ; drug therapy ; pathology ; Penis ; pathology ; Radionuclide Imaging

OBJECTIVEPenile fracture, being defined as rupture of the tunica albuginea of the corpus cavernosum, is uncommon. Here, we analyze findings on our patients during a 10-year period and evaluate the role of retrograde urethrography.

METHODSFrom February 2002 to April 2012, 116 patients were admitted with penile fracture at Ghaem Medical Center. Patient history and physical examination were taken at their admittance to detect probable urethral injury. Before surgery, retrograde urethrography was performed in all patients. The size and site of the tunical rupture were recorded. Then the rupture of tunica albuginea was sutured with nonabsorbable (3-0 nylon) sutures and the ties were placed on the internal surface (continuous method). All patients were followed up for 12 months.

RESULTSPatients' mean age was (32.78 ± 10.61) years and ranged (16-62) years. The mechanism of trauma was sexual intercourse in 103 patients (89%) and masturbation in 13 patients (11%). The most common site of injury found after exploration was right (55%) and lateral (74%) of the corpus cavernosum. The size of the tunical rupture was from 0.5 to 3.0 cm (mean 1.88 ± 0.72). Three of the patients had Marphan's syndrome. Urethral injury was detected by retrograde urethrography in 4 patients (3%) who had macroscopic hematuria and urethrorrhagia. During 12 months follow-up, no complication was seen.

CONCLUSIONThere is no need to perform retrograde urethrography unless the patients have gross hematuria or urethrorrhagia. The key to success in treatment of penile fracture is to achieve a rapid diagnosis based on history and a physical examination, avoid unnecessary imaging tests and perform immediate surgery to reconstruct the site of injury.

Adolescent ; Adult ; Humans ; Male ; Middle Aged ; Penis ; injuries ; surgery ; Rupture ; Sutures ; Urethra ; diagnostic imaging ; Young Adult

OBJECTIVETo evaluate the diagnosis and treatment of high-flow priapism (HFP).

METHODSFour cases of HFP following blunt trauma to the penis or perinea underwent diagnostic examination by colour-flow Doppler ultrasound and/or superselective pudendal arteriography, which revealed bilateral arteriocorporal fistula in 1 case and monolateral in the other 3. Penile detumescence was obtained in 2 cases by superselective bilateral/monolateral arteriographic embolization of the pudendal artery with absorbable gelatin

RESULTSThe former 2 cases effected an immediate recovery of the sponge, while the other 2 cases received conservative treatment. Erectile function, able to perform normal sexual intercourse in approximately 2 months. But in the latter 2, follow-up revealed unsatisfactory potency.

CONCLUSIONSuperselective arteriographic embolization with absorbable gelatin sponge can provide a safe, selective and effective treatment for HFP patients.

Adult ; Angiography ; Arteries ; Embolization, Therapeutic ; Humans ; Male ; Penis ; blood supply ; Priapism ; diagnostic imaging ; therapy

OBJECTIVESTo evaluate the clinic value of doppler ultrasonography in diagnosis of vasculogenic erectile dysfunction (ED).

METHODSThe hemodynamic change was obsreved by doppler ultrasonography during the erection of penis and the results between patients with vasculogenic ED and controls were compared. The doppler ultrasonographic characteristics of vascular ED was analyzed.

RESULTSIn the patients with arterial ED the peak systolic velocity(PSV) in deep artery was apparently lower than controls(P < 0.01), and in the patients with venous ED, the velocity of deep dorsal vein was higher during complete erection than controls(P < 0.05).

CONCLUSIONSThe result of doppler ultrasonography examination effectively helps the diagnosis of vasculogenic.

Adult ; Humans ; Impotence, Vasculogenic ; diagnostic imaging ; Male ; Penis ; blood supply ; Regional Blood Flow ; Ultrasonography, Doppler, Color

BACKGROUND AND OBJECTIVEIn computed tomography (CT)-based radiotherapy planning for prostate cancer, it is difficult to precisely delineate the prostatic apex because of its relationship with the urogenital diaphragm and bulbospongiosus musculature. In this retrospective study, we analyzed the magnetic resonance imaging (MRI) and CT scans of the patients with prostate cancer to investigate the relationship between the prostatic apex and the anatomic structure visible on CT, and to provide evidence for localizing the prostatic apex in radiotherapy planning.

METHODSMRI and CT scans of 108 patients with prostate cancer were analyzed to measure the distances between the prostatic apex and the bottom of ischial tuberosities, the bottom of obturator foramen, the bottom of pubic symphysis, and the bulb of the penis. The volume of the prostate was measured to analyze its relationship with the localization of the prostatic apex.

RESULTSThe prostatic apex was located (13.1±3.3) mm above the bulb of the penis, (11.0±5.4) mm above the bottom of the obturator foramen, (31.3±5.5) mm above the ischial tuberosities, and (7.1±4.7) mm above the bottom of the symphysis pubis. There was no correlation between the size of the prostate and the localization of the prostatic apex.

CONCLUSIONSThe variance of the distance between the prostatic apex and the bulb of the penis is smaller than that of the distance between the apex and bony anatomy. Delineating the target to 6 mm above the bulb of the penis can cover the prostatic apex in 95% of the patients with prostate cancer, delineating to the bottom of obturator foramen can cover the prostatic apex in 100% of the patients.

Humans ; Magnetic Resonance Imaging ; Male ; Penis ; diagnostic imaging ; pathology ; Prostate ; diagnostic imaging ; pathology ; Prostatic Neoplasms ; diagnosis ; diagnostic imaging ; radiotherapy ; Pubic Bone ; diagnostic imaging ; pathology ; Radiotherapy Planning, Computer-Assisted ; Tomography, X-Ray Computed ; methods