A Novel Non-Invasive Ultrasound Vibro-Elastography Technique for Assessing Patients with Erectile Dysfunction and Peyronie's Disease

Erectile dysfunction (ED) is a common condition that is characterized by progressive corporal smooth muscle fibrosis. There is currently no widely accepted methods to characterize the extent and severity of penile fibrosis.

The purpose of this study is to translate a novel ultrasound vibro-elastography (UVE) technique for noninvasively measuring viscoelasticity of the penis.

A pilot study was performed of UVE in men with ED and/or Peyronie's disease (PD). Assessments were performed in triplicate on the lateral aspect of the penis (bilaterally) at 100, 150, and 200 Hz prior to and following erectogenic injection administration. Viscoelasticity of the corpora was also calculated and compared pre and post-injection and against measures of erectile function including the International Index of Erectile Function (IIEF-EFD), and the total erectogenic medication volume required for achieving a firm erection.

Significant increases in viscoelasticity were found after erectogenic injection validating the ability of UVE to measure dynamic changes with erections. Baseline measures also significantly correlated with the volume of erectogenic medication required to achieve an erection (100 Hz, parameter estimate [PE] 2.21, p<0.001; 150 Hz, PE 0.53, p=0.03; 200 Hz, PE 0.34, p=0.07) but not with age and IIEF-EFD. As erectogenic medications likely represent the most accurate measure of erectile function, these findings suggest a potential role for UVE as a viable diagnostic modality for ED.

This first report of the use of elastography with erectile function in humans demonstrates significant associations with responsiveness to erectogenic injection medications. These data have significant potential implications for broader clinical practice and merit further study and validation.

Urology. 2018 Mar 13 [Epub ahead of print]

Xiaoming Zhang, Boran Zhou, Andre Miranda, Landon W Trost

Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA. Electronic address: ., Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA., Departments of Urology, Mayo Clinic, Rochester, MN 55905, USA.