Penile ultrasound for erectile dysfunction, peyronies, and pelvic floor

Ultrasound scanning provides clarity in determining the right treatment method

At the clinic, I have one of the most advanced Sonosite scanners for point-of-care ultrasound—a Sonosite LX. In a short amount of time, I can obtain images with unprecedented clarity, which help identify the severity of your condition and thereby serve as the basis for selecting the treatment method and its scope. I have 5 probes available, allowing me to perform a wide range of scans

That’s why ultrasound scans at MS Insight are different

There is a big difference between a standard scan and the type of exam I offer.

At MS Insight, you’ll receive:

• Advanced, high-resolution Doppler ultrasound
• Functional scanning—not just structural
• Specialized knowledge in men’s health
• Assessment of both the penis and the pelvic floor
• A direct link between diagnosis and treatment

While others focus on just one area, I look at the whole picture.

This leads to a much more accurate diagnosis—and better outcomes with subsequent treatment.

When Ultrasound Is Useful for Erectile Dysfunction

Erectile dysfunction can be caused by several different conditions. For some men, the problem is mainly about blood flow. For others, medication, diabetes, nerve damage, previous surgery, scar tissue, Peyronie’s disease, hormones, pelvic floor or psychological factors play a bigger role. Therefore, ultrasound is not necessarily relevant for everyone – but in the right situation, the examination can provide important information that cannot be assessed by symptoms alone.

For erectile dysfunction, ultrasound may be relevant when there is a suspicion that the tissue or blood flow in the penis plays a significant role. For example, if the erection has gradually become weaker, if tablets such as Viagra or Cialis work insufficiently or unsteadily, if you have diabetes or known circulatory risk factors, or if there is pain, curvature or noticeable changes in the penis.

At MS Insight, ultrasound is used as part of a comprehensive evaluation. The scan is not a standalone test and does not automatically provide answers to the entire problem. However, it can help determine whether there are signs of tissue changes, scar tissue, plaque, or other conditions that would make a more targeted treatment plan appropriate.

If you’re experiencing recurring problems with erections, you can read more about erectile dysfunction and its treatment.

Blood flow, scar tissue, and structural changes

An erection depends, among other things, on the blood flowing to the penis, the tissue being able to expand, and the mechanisms that help maintain the erection working properly. When a man experiences erectile dysfunction, it is therefore relevant to distinguish between a problem that is primarily about sexual desire or situation and a problem where tissue or blood flow may be affected.

Ultrasound can be used to examine penile tissue and identify structural changes that may affect function. These may include thickening, scar tissue, fibrosis, plaque, or other changes in the tissue that are not always visible from the outside. When appropriate, Doppler ultrasound can also be used to assess blood flow.

This does not mean that all erectile problems can be explained by a scan. A man may have significant symptoms without any obvious structural findings, just as a finding on an ultrasound is not necessarily the entire explanation for the problem. However, if a physical or vascular component is suspected, ultrasound can make the assessment more precise.

This can be important, for example, if you:

• Are experiencing a gradual decline in erectile function.
• Have diabetes, high blood pressure, or other cardiovascular risk factors.
• Have tried Viagra, Cialis, or similar pills without satisfactory results.
• Have pain, notches, curvature, or noticeable areas on the penis.
• Have developed problems following surgery, injury, or a prolonged illness.

Ultrasound does not replace a comprehensive assessment of medications, hormones, lifestyle, nerve function, or psychosexual factors. It is used when the imaging suggests that information about tissue and blood flow may alter the next course of action.

Also read about erectile dysfunction and medications if oral treatment appears to be inconsistent or insufficient.

Ultrasound for Peyronie’s disease, plaque, and penile curvature

In Peyronie’s disease, changes occur in the connective tissue around the penis, which can lead to plaque, curvature, notches, an hourglass shape, pain, or impaired function. Some men notice a hard change in the tissue themselves. For others, the problem is primarily visible during an erection or is experienced as a change in shape, length, or stability.

Ultrasound can be relevant for Peyronie’s and torticollis because the examination can help localize tissue changes and show if there is calcification or other structural findings. It can be particularly relevant when symptoms are not just about curvature, but also pain, decreased erection, notching or uncertainty about what has actually happened to the tissue.

However, the scan should be used with caution. In Peyronie’s disease, the severity of the condition is not assessed based on the size of the plaque alone. Key factors also include how long the symptoms have persisted, whether pain or progression continues, the degree of penile curvature, whether sexual intercourse is affected, and whether erectile function has simultaneously deteriorated. Ultrasound is therefore a supplement to the clinical evaluation—not a definitive diagnosis on its own.

At MS Insight, ultrasound is included in the evaluation when it can help determine:

• Where the tissue changes or plaque are located.
• Whether there is calcification or obvious structural changes.
• Whether the symptoms are related to erectile dysfunction.
• Whether there are factors that affect realistic expectations for treatment.
• Whether further evaluation or a targeted treatment strategy is appropriate.

If you’ve developed a new curve, indentation, pain, or noticeable changes in your penis, you can read more about Peyronie’s disease treatment.

When a previous illness or surgery is a factor

Erectile dysfunction can occur after an illness, surgery, or treatment in the pelvic area. This includes, for example, prostate surgery, radiation therapy, other pelvic surgeries, or procedures in which nerves, blood vessels, or tissues may have been affected. In cases of diabetes, both vascular and nerve function may simultaneously contribute to weaker erections or to pills being less effective than expected.

In these situations, it is rarely sufficient to simply note that erections are not functioning as they did before. The relevant question is which aspects of function may be affected and what that means for the next steps.

In selected cases, ultrasound can help assess tissue or structural conditions after disease or surgery. Not only can it tell if a nerve is damaged or if erectile function can be regained. However, it can help reveal if there are concomitant changes in tissue or blood flow that should be taken into account.

After prostate surgery, erectile dysfunction may, for example, be related to damage to the neurovascular structures, while diabetes can affect both blood vessels and nerves over time. This means that the right treatment plan isn’t necessarily the same for every man—even if the symptom is the same.

At MS Insight, we therefore look at the full picture: previous illnesses or surgeries, function before and after the course of treatment, response to medication, any structural findings, and your goals for treatment and sexual function.