Penile sonoelastography for the localization of a non-palpable, non-sonographically visualized lesion in a patient with penile curvature from Peyronie's disease.

INTRODUCTION Sonoelastography is an emerging ultrasound-based technique that allows characterization of tissue stiffness. AIM The aim of this report is to present a case of significant penile curvature with a non-palpable, non-sonographically visualized plaque that was demonstrable with sonoelastography. METHODS A 60-year-old male presented with significant left penile curvature during erections. The penis was evaluated with physical exam followed by B-mode and color Doppler ultrasound. No evidence of plaque was identified with these modalities. Shear wave sonoelastography was pursued to further characterize the patient's Peyronie's disease. RESULTS An area of increased tissue stiffness that correlated with the site of maximum curvature was identified with shear wave sonoelastography and used to target intralesional injection therapy. CONCLUSION Sonoelastography provides an additional way to characterize, localize, and deliver therapy to a lesion in patients with Peyronie's disease and is particularly useful when palpation and B-mode ultrasonography have failed to demonstrate a plaque.