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Penile scintigraphy with 99m Tc‐human immunoglobulin G: a novel method for distinguishing the unstable and stable phases of Peyronie's disease
Author(s) -
Erdogru T.,
Boz A.,
Köksal T.,
Usta M.F.,
Yildiz A.,
Güngör F.,
Baykara M.
Publication year - 2002
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1046/j.1464-410x.2002.03010.x
Subject(s) - medicine , nocturnal penile tumescence , scintigraphy , urology , peyronie's disease , papaverine , tumescence , antibody , occlusion , immunoglobulin g , surgery , penis , nuclear medicine , erectile dysfunction , immunology , erectile function
Objective To investigate the value of penile scintigraphy using 99m Tc‐human immunoglobulin G (IgG) to differentiate the unstable (acute) and stable (chronic) phases of Peyronie's disease (PD). Patients and methods Thirty‐two consecutive patients (25 with PD and seven without) were evaluated using a detailed sexual history, serum chemistry panel, colour Doppler ultrasonography during simultaneous intracavernosal injection of 50 mg papaverine and stimulation, and 99m Tc‐IgG scanning. When indicated, nocturnal penile tumescence monitoring, dynamic infusion cavernosometry, cavernosonography and cavernosal artery systolic occlusion pressure were measured. After administering 370 MBq of 99m Tc‐IgG, images were taken at 30 min, 1, 2, 3 and 4 h. The scans were considered positive if there was any focal accumulation of radiopharmaceutical consistent with PD plaque formation. Results Eleven of the 25 patients with PD (mean age 56 years, sd 8) were in the unstable phase, the remaining 14 being in the stable phase. There was a localized increase in 99m Tc‐IgG activity in 10 patients who had unstable PD. There was complete resolution of increased activity in two patients at 12 and 13 months of follow‐up. Of the 14 patients in the stable phase, 12 (at > 1 year) showed neither increased nor decreased 99m Tc‐IgG activity. In the remaining two patients there was increased activity on the plaque side. There was no local increase in activity in the control group. Conclusion Inflammatory reactions can develop at various intervals during the unstable phase of PD. Medical methods should be used during the unstable phase and surgery delayed until the stable phase of the disease begins. An objective method of differentiating between the phases is therefore important. Penile 99m Tc‐IgG imaging is a new diagnostic approach for confirming the unstable phase of PD.