One of the most important tests for erectile dysfunction and Peyronie’s is penile ultrasound combined with Doppler. It provides vital data to guide the next steps—right up to a possible penile-prosthesis surgery.
Before ultrasound, the urologist reviews medical history and performs a physical exam—both flaccid and pressurised—to assess fibrotic plaques and any deformities, plus shaft rigidity.
The complementary exam for ED and Peyronie’s disease is penile ultrasonography (ecography). Patients should strongly prefer Doppler ultrasound rather than a simple scan without erection induction, because Doppler reveals the vascular interior.
Clinical History & Physical Exams
The first step in investigating suspected erectile dysfunction or Peyronie’s disease is the clinical history (anamnesis).
From childhood to the present, the physician builds a rich health timeline that guides diagnosis and decisions. In general the anamnesis collects:
- Physical details (height, weight, exercise, chronic meds)
- Recent history (illnesses, surgeries, complaints)
- Chronic diseases (diabetes, hypertension, obesity, asthma)
- Family history
- Patient-reported particulars
Then come three key physical assessments:
Inspection & Palpation
With trained hands the urologist detects palpable plaques in both flaccid and erect states. A BJU International study shows many plaques feel like nodules.
Drug-Induced Erection
A vasoactive agent lets the doctor evaluate curvature degree, narrowing, shortening, burial, etc., and compare with anamnesis.
Rigidity Test
This in-office test checks whether the penis can overcome vaginal resistance or struggles to penetrate.
Penile Doppler Ultrasound: How It Works
After initial exams, the physician may order this add-on.
Standard ultrasound studies morphology; Doppler adds vascular flow (arteries & veins), enabling simultaneous diagnosis of Peyronie’s disease and erectile dysfunction.
When performed after intracavernosal vasodilator injection, an erection occurs without arousal—hence “pharmaco-induced ultrasound.”
The procedure is painless and lasts only a few minutes; key images are captured for the final report and surgical planning.
How to Schedule a Penile Ultrasound
A prior urology consult is essential. If ED symptoms are absent the test may be unnecessary, but when indicated it’s ideal the operating surgeon performs the scan for full detail.
At the Egydio Medical Center all tests can be done during the same visit by Dr Paulo Egydio.
Doppler Ultrasound: Cost
Costs vary by clinic and are higher than basic morphologic ultrasound because Doppler technology is more complex.
What Does Penile Doppler Reveal?
For patients with suspected ED or Peyronie’s we learn:
- Status of cavernous bodies
- Intracavernous plaques
- Plaque extension in tunica albuginea
- Calcifications
- Arterial & venous flow quality
- Presence of arterial insufficiency or veno-occlusive dysfunction (venous leak)
- How much expansion is lost
The exam also shows:
- Exact vessel paths
- Whether all arteries are present or blocked
- Quality of dorsal arterial flow
This reduces surgical risk and complications by providing a vascular map.
Penile Ultrasound in Patients with Implants
The exam also benefits previously implanted patients by revealing calibre, model and brand. With an inflatable prosthesis it shows cylinder angle or reservoir status and may indicate a prosthesis replacement for better axial rigidity.
Still have questions about tests for erectile dysfunction and Peyronie’s? Message us on WhatsApp or visit our clinic for complete answers.
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