Pre Treatment work-up
After erection was achieved by intracavernosal alprostadil injection, the maximum plaque size was measured before and after treatment by performing penile duplex doppler ultrasound in all patients. During the same procedure, the physician investigated whether there was calcified plaque. During erection, curvature angle was measured using a goniometer protractor. The point of injection was determined by marking the maximal curvature point, and the necessity of erection was eliminated before each procedure. To determine the point of maximum curvature, starting at the base of the penis, a straight line was drawn through the center of the straight portion of the penile shaft proximal and distal to the point of maximum curvature. The intersection of these lines was accepted as the maximal point of curvature, and the degree of curvature was determined by measuring the angle between these lines.
Before the first injection and one month after the last injection, all patients were assessed with Peyronie’s Disease Questionnaire (PDQ), consisting of 15 questions, and the International Index of Erectile Function (IIEF-5), consisting of 5 questions [12]. The score obtained from questions 1-6 of the PDQ questionnaire evaluates symptom severity (PDQS), questions 7-9 evaluate penile pain (PDQP), and questions 10-15 evaluate bother/discomfort symptoms (PDQB) [13].