Our cross-sectional study of 154 patients with Peyronie's disease shows that the severity of penile curvature does not correlate with the hemodynamic parameters measured by dynamic penile color Doppler ultrasound. In clinical practice, there are conflicting data regarding possible inaccuracies in dynamic penile color Doppler ultrasound (CDDU) measurements in men with penile curvature secondary to Peyronie's disease. Understanding the relationship between the degree of curvature and penile hemodynamic parameters is essential for the correct diagnostic and therapeutic management of these patients. Our objective was to explore the relationship between the degree of penile curvature and CDDU parameters in men with Peyronie's disease.
Our researchers prospectively collected and analyzed complete clinical data from 154 consecutive men who presented at a single academic center with Peyronie's disease as the main reason for consultation. All patients underwent CDDU. Penile curvature was measured using a goniometer at the time of maximum erection during the CDDU examination. Patients were stratified according to CDDU parameters into two groups: normal CDDU (mean peak systolic velocity [PSV] ≥35 cm/s and resistance index [RI] ≥0.85) and pathological CDDU (mean PSV less than 35 cm/s and/or RI less than 0.85). Descriptive statistical analysis compared the two subcohorts, while linear regression models explored the association between penile curvature degree and dynamic CDDU parameters.
The median age of the cohort was 56 years (interquartile range 48-63). The median PSV and median degree of penile curvature were 48.8 cm/s (37.9-58.5) and 40 degrees (30-60), respectively. On CDDU examination, penile curvature degrees were distributed as follows: 10-30 degrees in 63 patients (40.9%), 30-70 degrees in 70 patients (45.5%), and 70-90 degrees in 21 patients (13.6%). Overall, 116 patients (75.3%) had a PSV >35 cm/s and an IR ≥0.85. Patients with abnormal CDDU parameters did not differ from those with normal parameters in terms of median curvature (32.5° vs. 40°; p = 0.5) or distribution across the different curvature range groups. Linear regression analysis revealed that the degree of penile curvature did not correlate with PSV on CDDU examination (coefficient: 0.06; p = 0.3).
The clinical implications are significant: our study confirms the absence of correlation between penile curvature severity and CDDU parameters in men with Peyronie's disease. These findings are important for a more accurate diagnostic-therapeutic process for patients with Peyronie's disease and have significant medico-legal implications in daily clinical practice, confirming that the assessment of penile vascular function must be conducted independently of the extent of curvature.
Bertini A, Pozzi E, Belladelli F, Raffo M, Corsini C, Negri F, Musso G, Cattafi F, Ramadani R, Candela L, Arma A, Montorsi F, Salonia A. Penile curvature severity in patients with Peyronie’s disease does not correlate with dynamic color Doppler duplex ultrasound parameters: findings from a real-life cross-sectional study. Andrology. 2025 Sep;13(6):1462-1468. doi: 10.1111/andr.13771. Epub 2024 Sep 30. PMID: 39350575.
