Predicting the progression of Peyronie's: An utrasound study

It's a mark of how under-studied Peyronie's has been that we're only now beginning to understand the course of the disorder (see also). These Greek researchers divided their study group up based on initial ultrasound, then followed their course for a year without intervention (emphases mine):

The Natural History of Peyronie's Disease: An Ultr...[Eur Urol. 2007] - PubMed Result

Eur Urol. 2007 Jul 17
The Natural History of Peyronie's Disease: An Ultrasonography-Based Study.
Bekos A, Arvaniti M, Hatzimouratidis K, Moysidis K, Tzortzis V, Hatzichristou D.
Center for Sexual and Reproductive Health and 2nd Department of Urology, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Greece.

OBJECTIVES: To define ultrasonographic patterns reflecting different states of Peyronie's disease (PD) and to use them to evaluate the natural history of the disease.

MATERIAL AND METHODS: Diagnosis of PD was based on medical and sexual history, physical examination, intracavernosal injection test, and penile ultrasonography. Patients with penile fracture history were excluded from the study. Three groups were formed according to ultrasonographic patterns: solitary hyperechoic lesion without acoustic shadow (group A), moderately hyperechoic multiple scattered calcified lesions with acoustic shadows (group B), dense calcified hyperechoic plaque with acoustic shadow (group C). All patients entered a watchful waiting protocol for 1 yr followed by a new penile ultrasonography.

RESULTS: Ninety-five 95 patients with PD were included in the study (mean age, 57.2+/-9.1 yr; mean duration of disease, 12.9+/-8.9 mo). Risk factors associated with cardiovascular disease were present in 79 of 95 patients (83.16%). Eleven (11.6%), 35 (36.8%), and 49 (51.6%) patients were classified into groups A, B and C, respectively.

At the end of the study, in group A, reduction of fibrotic lesions and curvature angle was noticed in 9 of 11 (81.8%) patients, whereas plaque formation was noticed in 2 of 11 (18.2%) patients. In group B, plaque and curvature reduction was noticed in 15 of 35 (42.9%) and 12 of 35 (34.3%) respectively, whereas in the rest a dense calcified plaque was noticed. In group C, no ultrasonographic evidence of improvement was noticed; curvature angle was reduced in 4 of 49 (8.2%), owing to the extension of the plaque circumferentially. Significant hemodynamic changes were noticed at the two time points tested (30.53% diagnosed with vascular disease at baseline vs. 46.32% at the end of the study, p=0.03).

CONCLUSIONS: Corporal ultrasonography in patients with PD allows objective evaluation and classification of disease. The density of echogenic areas and presence of acoustic shadows are predictors of disease stability.

PMID: 17673362 [PubMed - as supplied by publisher]

If this holds up urologists will be better decide when aggressive treatment is indicated. The overall news was not encouraging and is line with other recent studies of disease course. This was an older population and thus might be expected to have less aggressive disease, but in fact only 11% fell into the "good" group at the start of the study. Half were in the "bad" group at the start and none of them improved.