Penile ultrasound for erectile dysfunction, peyronies, and pelvic floor

Ultrasound is not just a scan. In the right context, it’s a tool that can change assessment, expectations and treatment choices.

For erectile dysfunction, scanning may be relevant when altered blood flow, scar tissue, plaque, structural changes or sequelae from disease, surgery or prolonged strain are suspected.

For Peyronie’s and penile torsion, ultrasound can also provide a more precise understanding of where the changes are and what that means for the plan moving forward.

Michael Strøm

Expert in shockwave for men's health & international speaker.

What can an ultrasound scan of the penis show?

An advanced ultrasound scan of the penis provides a unique insight into the structures and functions that are crucial for your sexual health, such as:

Blood flow in the penis
Tissue quality in the tumor bodies
Calcifications and plaque in Peyronie’s disease
Microchanges in the tissue that are not yet noticeable
Pelvic floor function and control
Signs of inflammation or irritation in the tissue
Size of the prosta
The ability to empty the bladder

Ultrasound scans provide clarity to find the right treatment method

In the clinic, I have one of the most advanced scanners from Sonosite for point of care ultrasound scanning, a Sonostite LX. In a short time, I can get images of unprecedented clarity, which helps to reveal the extent of your problem and thereby use it as a basis for choosing the treatment method and extent. I have 5 probes available, so I can do a wide range of scans

Why ultrasound scanning at MS Insight is different

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

At MS Insight you get:

Advanced Doppler ultrasound with high resolution
Functional scanning – not just structure
Specialized knowledge in men’s health
Assessment of both penis and pelvic floor
Direct link between diagnosis and treatment

While others only look at one area, I see the big picture.

This results in a much more accurate diagnosis – and better results for subsequent treatment.

When ultrasound makes sense 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 an overall assessment. The scan does not stand alone and does not automatically provide an answer to the whole problem. But it can help clarify if there are signs of tissue changes, scar tissue, plaque or conditions that make a more targeted plan make sense.

If you experience recurring problems with erection, read more about erectile dysfunction and impotence 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 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 doesn’t mean that all erectile dysfunction can be explained by a scan. A man can have significant symptoms without clear structural findings, just as a finding on ultrasound may not be the whole explanation for the problem. However, if a physical or vascular component is suspected, ultrasound can make the assessment more accurate.

Among other things, this can be important if you:

Experiencing a gradual deterioration in erectile function.
Have diabetes, high blood pressure or other circulatory risk factors.
Have tried Viagra, Cialis or similar pills without satisfactory effect.
Have pain, indentation, curvature or noticeable areas in the penis.
Experiencing problems after surgery, injury or prolonged illness.

Ultrasound does not replace an overall assessment of medication, hormones, lifestyle, nerve function or psychosexual conditions. It is used when the image suggests that information about tissue and blood flow can change what makes sense next.

Read also about erectile dysfunction and pills if tablet treatment seems unstable or insufficient.

Ultrasound for Peyronie’s, plaque and crooked penis

Peyronie’s disease causes changes in the connective tissue around the penis, which can lead to plaque, curvature, notching, hourglass shape, pain or reduced function. Some men notice a hard change in the tissue themselves. For others, the problem is primarily visible during 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, the significance of the disease is not assessed by the size of the plaque alone. It also depends on how long the symptoms have been present, whether there is continued pain or development, how much the penis curves, whether sexual intercourse is affected and whether the erection has also deteriorated. Ultrasound is therefore a supplement to the clinical assessment – not an isolated checklist.

At MS Insight, ultrasound is included in the assessment when it can help to understand:

Where the tissue change or plaque is located.
Whether there is calcification or obvious structural changes.
Whether the symptoms are related to erectile dysfunction.
Whether there are conditions that affect realistic treatment expectations.
Whether further assessment or a targeted treatment strategy makes sense.

If you have a new curvature, indentation, pain or noticeable changes in the penis, read more about Peyronie’s disease treatment.

When previous illness or surgery comes into play

Erectile dysfunction can occur after illness, surgery or treatment in the pelvic area. This includes prostate surgery, radiation therapy, other pelvic surgery or procedures where nerves, blood vessels or tissue may have been affected. In diabetes, both vascular function and nerve function can be part of the reason why erections become weaker or why pills work worse than expected.

In these situations, it is rarely enough to simply state that the erection is not functioning as before. The relevant question is which parts of the function may be affected and what this means for the future plan.

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.

For example, after prostate surgery, erectile dysfunction can be linked to the impact on neurovascular structures, while diabetes can affect both vessels and nerves over time. This means that the right plan is not necessarily the same for every man – even if the symptom is the same.

At MS Insight, we look at the whole picture: previous disease or surgery, pre- and post-procedure function, response to medication, any structural findings and your goals for treatment and sexual function.

Read more about impotence after prostate surgery or the overall assessment of erectile dysfunction and impotence.

How scanning can change expectations and treatment choices

An ultrasound scan is not valuable because it automatically leads to a specific treatment. It’s valuable when it helps make the next step more precise.

If the scan shows tissue changes, plaque, calcification or conditions that support the suspicion of a physical component, it can influence which options are relevant and what expectations are realistic. If the scan doesn’t show the changes you suspected, it can be just as important because it may indicate that other factors should be given more weight.

For erectile dysfunction, this may mean focusing on medication, circulation, diabetes, hormones, nerve function, psychosexual conditions or a combination. For Peyronie’s, the findings can help to understand the nature of the disease and set more precise goals for pain, function, curvature and treatment.

For selected men with a likely vascular component, shockwave therapy for impotence may be relevant. If Viagra or Cialis is unstable or inadequate, the goal for some may be to improve physical function and potentially achieve a better response to the pills. It is not automatically chosen based on one finding, but based on the overall assessment.

At MS Insight, ultrasound can therefore help to clarify:

Whether the issue is likely to have a physical or structural component.
Whether plaque, scar tissue or Peyronies play a role.
Whether previous illness or surgery affects the plan.
Whether a treatment option seems relevant – or whether it should be abandoned.
What goals and expectations are realistic in your particular situation.

It provides a more honest and individualized plan. Not because a scan can explain everything, but because in the right cases it can make it clearer what makes sense to work on.

In my practice, ultrasound scanning is a key part of a thorough examination so that treatment is targeted and effective.

Ultrasound scan of the pelvic floor

The pelvic floor plays a much bigger role in erection, ejaculation and bladder function than most people realize.

By scanning, I can assess:

Activation and control of pelvic floor muscles
Tension state (overactive vs. weak pelvic floor)
The interaction between muscles and nerves
Possible causes of incontinence or urgency

This is especially relevant when:

Incontinence
Frequent urination
Pain in the pelvic area
Problems with control during sex

How does an ultrasound scan work?

The examination is thorough, but takes place in a calm and safe environment in a room where no one else can gain access.

A typical course of events:

Conversation about your symptoms and history
Ultrasound scan of relevant areas
Review findings in real-time
Treatment plan based on results

In many cases, we can start treatment on the same day to save time.

From diagnosis to treatment

Ultrasound scanning is not an end in itself – it is the foundation for the right treatment.

Based on the scan, I can put together a targeted program that can typically include:

Shockwave therapy
EMTT (magnetic therapy)
Pelvic floor training
Optimizing blood flow
Lifestyle and sexuality advice

The goal is always the same:
To restore function, confidence and control.

Book an appointment for an ultrasound scan

If you want clarity on the cause of your symptoms and a concrete plan on how to treat them, the first step is a thorough examination.

You’re welcome to book a consultation to find out what’s behind your challenges and what it takes to solve them.

Michael Strøm og MS Insight

Denne side er fagligt udarbejdet af Michael Strøm, specialist i shockwave, EMTT og mænds seksuelle sundhed. Hos MS Insight møder du Michael direkte i klinikken, så vurdering, behandling og opfølgning hænger tæt sammen fra start.

Siden bygger på klinisk erfaring fra MS Insight, relevant forskningslitteratur og en individuel vurderingsmodel, hvor symptomer, funktion, væv, blodgennemstrømning, nervesystem og behandlingsmål ses i sammenhæng.

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FAQ

How does the ultrasound scan at MS Insight differ from the one you get at your GP?

At MS Insight, we typically use an ultrasound scanner with higher image quality than what you see at your GP or public urologist. We use high-frequency transducers with the ability to perform advanced double scans of organs, muscles and other structures in the body. MS Insight evaluates the tissue quality of the pelvic floor and penis for sexual dysfunction and pain. We can scan in both erect and relaxed states.

Is ultrasound for erectile dysfunction and peyronies painless and without side effects?

Yes, there are no pain or side effects associated with ultrasound scans for erectile dysfunction and peyronies. The only “side effect” is that you get clarity on your problem. With ultrasound for peyronies and erectile dysfunction, you get a thorough assessment and evaluation of the extent of the problem in a safe and effective way.

What can we see on an ultrasound scan for erectile dysfunction and peyronies at MS Insight?

When you get an ultrasound scan for erectile dysfunction or peyronie’s disease, we will focus on whether there is peyronie’s plaque, degenerative changes and how your blood flow is in the penis. In addition, we do screenings of the heart’s pumping function to see if it could be part of the cause of erectile dysfunction. So MS Insight is your go to place for men’s sexual health and ultrasound scanning in particular. We also do a scan of both bladder and prostate if relevant.

Can I get an ultrasound scan without a referral?

Yes, you can book an appointment directly with MS Insight for ultrasound scans for sexual dysfunctions such as peyronies, erectile dysfunction, incontinence and pudendal nerve problems. No referral is required, but with full co-payment we offer quick clarification and specialized assessment.

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Er du interesseret i at høre mere om, hvordan vi kan hjælpe dig, er du altid velkommen til at kontakte os på telefon: 41 40 08 58 eller mail: michael@msinsight.dk. Otherwise, fill out the contact form with your details and a brief description of your problem. I’ll get back to you quickly with a customized solution proposal so we can find the best way forward together.