The preferred approach to evaluate the patient with Peyronie’s disease is to perform a dynamic duplex ultrasound during which the initial scanning of the penis will determine if there is scarring in the corpora cavernosa and to identify calcification of the plaque if it is there. The patient would then receive a chemically induced erection so that there can be assessment of erectile response which would be compared to his home erection, and hopefully a full erection would occur which would allow objective measurement of deformity. The cavernosogram technique is a bit more invasive, likely more costly and is probably not useful unless there is suggestion on the duplex ultrasound that there is evidence of significant venous leakage. Physicians often times have their own approach to the evaluation of Peyronie’s, and some still prefer the use of the cavernosogram but the preferred imaging approach appears to be screening with a duplex ultrasound first.
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