Introduction: Intracavernosal injections (ICI) and penile ultrasound (PUS) play diagnostic roles for patients with erectile dysfunction (ED) and Peyronie's disease (PD). They can help to identify vascular and anatomical changes that may guide medical and surgical management; however, contemporary utilization rates of ICI and PUS have not been described. Our objective was to evaluate the rates of ICI and PUS utilization in patients with ED and PD using a multi-center global database. Methods: We queried the TriNetX database for adult men based on ICD-10 codes with ED (N52) being medically treated with phosphodiesterase (PDE)-5 inhibitors and patients with PD (N48.6) from 2002-2022. CPT codes were then utilized to identify patients who underwent further evaluation with intracaversonal injection (54235) alone and PUS (93980, 93981). CPT codes were also utilized to identify subsequent treatment with injection therapy for PD (54200), penile plication (54360), plaque excision +/- grafting (PEG) (54110, 54111, 54112), and penile prosthesis (54400, 54401, 54405). Results: The cohort with ED on a PDE-5 inhibitor in the TriNetX database included 627,614 patients. 9,097 patients (1.4%) had a PUS and of those, 965 (10.6%) underwent penile prosthesis placement (Figure 1A). The cohort with PD included 46,175 patients. PUS was performed in 5,382 (11.6%) patients with PD. Of these patients, 1,025 (19%) then underwent injection treatment, 506 (9.4%) penile plication, 280 (5.2%) PEG, and 584 (10.9%) penile prosthesis placement (Figure 1B). ICI alone was performed in 3,243 (7%) PD patients. Of these patients, 636 (19.6%) then underwent injection therapy, 1,140 (35.1%) penile plication, 105 (3.2%) PEG, and 385 (11.9%) penile prosthesis placement (Figure 1B). Conclusions: PUS is infrequently utilized in patients with ED. In PD patients, PUS is used more commonly than ICI alone. After evaluation with PUS for PD, the most common therapy is injection. After an evaluation with ICI only, the most common therapy is penile plication. SOURCE OF Funding: None.
