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[Markyj]

Would an ultrasound and exam 1 month after injury be too soon to tell if there is an issue?

[Blake667]

I'm curious about this as well. It seems like everyone's experience is different. Even though the doctor I saw told me he couldn't feel any plaques, I've been worried that maybe that 4-6 minute exam was too early to tell. If you got the money to spare and you're experiencing pain, then go for it. It's your dick after all. Why take the chance? 

In my case, I'm probably going to see another Uro for exams (even though I'm not in pain)

[Logarn]

I went right after injury but I have no symptoms so I didn't get an MRI or ultrasound.  I think they think it is all in my head, maybe it is but I don't know.  I want some peace of mind at the very least from some imaging. Maybe they would be able to see some inflammation or lesions in the first month or two with good imagining even if it is not hardened yet

[TonySa]

I think it depends on if you have any symptoms...

[Logarn]

Why are urologists so reluctant to do imaging?  Is it really expensive or are they not trained for that unless they are specialists?

[RandyPE]

I'm not a Uro, but I am a doctor.  And I hate to "out" colleagues, but much of it is in them following the money.  Imaging is cheap, and insurances don't pay much, especially for how time consuming it can be to set it up, have images taken, and then read and interpreted, and then relay info to the patient.  I'm not condoning it, instead am condemning it and have been very vocal in my state board.

There's not much money in Peyronies Disease for a uro, unless he's doing an eventual implant, which most of them aren't even trained or qualified to do.  But in bladder stuff there's big money, and those problems apply to a larger demographic (men and women) than Peyronies Disease does.  So it is tough to find someone who's going to give you adequate time and attention for Peyronies Disease unless he truly specializes in it and has enough cases to build a practice around it.

BUT - you can and should insist on imaging if you think it's right for you. Absolutely. And note that any doctor can order imaging of any body part.  If your uro won't, but your GP is a good guy and you have a good relationship with him, ask him to.  It doesn't cost him anything at all to send you to an imaging center (he won't have US or MRI in his clinic likely), he just needs to write the order. I literally do it all the time, even for body parts I don't plan on treating. 

And they're often much cheaper without insurance than they are with.  I can order a cash MRI here (Arizona) for $275, where the insurance cost and even the patient portion after insurance, often exceeds $1000.  So even if your insurance won't cover it, you can go in on cash pay and get it done. But it has to be ordered by a doctor.

Hope that helps.

[Markyj]

Interesting.  Would a typical urologist be able to read the MRI and know if there was something wrong?  I don't know enough about them to know if it requires a very specialized skillset for that or if it is pretty obvious if something in your penis looks wrong on an mri. thanks!

[RandyPE]

Any imaging facility will provide a radiologist's interpretation of the study, which will go back to the ordering doctor.  Your average uro honestly probably wouldn't know what he was looking at on an MRI unless he sees a lot of them.  But the report would tell him the findings. 

It's just that MRI interpretation isn't taught in med school except to radiologists.  The rest of us look at them and once something is pointed out can "kind of" see the findings, but we're not trained to look at an MRI and find the details.

[Logarn]

Any imaging facility will provide a radiologist's interpretation of the study, which will go back to the ordering doctor.  Your average uro honestly probably wouldn't know what he was looking at on an MRI unless he sees a lot of them.  But the report would tell him the findings. 

It's just that MRI interpretation isn't taught in med school except to radiologists.  The rest of us look at them and once something is pointed out can "kind of" see the findings, but we're not trained to look at an MRI and find the details.

Thanks for info!  So it sounds like one could get a good idea whether something is wrong even if they can't see a peyronie's specialist with an MRI unless I am not understanding correctly.  So do you know if the radiologist can see things like inflammation that could lead to scarring in addition to plaques and calcifications.

[RandyPE]

Here's the scoop on imaging and things like inflammation and plaque:

If you see it, it's definitely there.

If you DON'T see it, it may still be there.

So imaging can be considered conclusive for things that it detects, but inconclusive for what it does not detect.  I know that seems weak, but it's true.

That's why I never took any of my 4 urologist's words for it.  Same thing with palpation (touching, feeling) - if he feels a plaque, it's there.  If he doesn't feel a plaque, it may be there.

Don't let any of them tell you it isn't there.  All they can/should tell you is that they don't see/feel/touch/whatever it.

Hope that helps.  Medicine is not (yet) a true science.  It's basically trial and error, but the best healthcare system we have (for now).