Penile ultrasound uses grayscale imaging combined with color and spectral Doppler to evaluate penile vasculature, cavernous tissue, and structural anatomy. Its primary clinical applications are in the evaluation of erectile dysfunction and Peyronie’s disease.
Dynamic penile duplex Doppler (DPDDU) is performed before and after intracavernous injection of a vasoactive agent (papaverine, prostaglandin E1) to assess cavernous artery response — peak systolic velocity, end-diastolic velocity, and resistive index. Low peak flow indicates arterial insufficiency; persistent diastolic flow suggests venous leak. In Peyronie’s disease, sonographers identify and measure fibrous plaques within the tunica albuginea and assess associated penile curvature.
Penile ultrasound is typically performed by sonographers with RDMS credentials and urology-specific training or by urologists using in-office ultrasound. It is offered in urology practices, men’s health clinics, and academic urology departments. The examination requires patient privacy and sensitivity, and results directly guide medical and surgical management of erectile dysfunction.