Prevalence of Peyronie's disease in men with erectile dysfunction

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Peyronie's disease (PD) is a localized connective tissue disorder that primarily affects the tunica albuginea and the areolar space between the tunica albuginea and erectile tissue.

The majority of men with PD retain the ability to obtain and maintain an erection. However, they may have difficulties in achieving vaginal penetration and sexual activity, as a result of curvature, pain on intromission or partner dyspareunia. Inadequate erections are reported in about 20% of patients with symptomatic PD.

A recent review by Ahmed El-Sakka from Makkah, Saudi Arabia, examined the prevalence of Peyronie’s disease among a population of men complaining of erectile dysfunction. Also analyzed were the risk factors and medical comorbidities in patients with this disease. The review is published in the March, 2006 issue of European Urology.

A prospective office-based study was performed from December 2001 to December 2004 and 1,440 male patients with a clinical diagnosis of ED were enrolled in the study. Patients were interviewed for ED using the IIEF. Patients were also interviewed for socio-demographic factors and relevant medical history. Socio-demographic factors included age, obesity and smoking habits. Medical history and risk factors included diabetes, hypertension, dyslipidemia, and psychological disorders. The diagnosis of Peyronie’s disease was based on a penile plaque on routine examination of the penis, or acquired penile curvature that was confirmed by using an intracorporeal injection of 10mcg of prostaglandin E1.

Of the 1,440 patients, 84% were sexually active. 11.8% of the total had mild, 38.3% had moderate and 49.9% had severe ED. 11.3% of the patients had low testosterone levels and 9.2% had hyperprolactenemia. Analysis of the results showed that 7.9% of the patients had Peyronie’s disease; of those 27.2% had sought medical advice at the time of screening. The remaining patients were detected during examination. Mean age of the patients were 54.1 years and 52.5 years for patients with and without PD respectively. Of the patients, 12.9% were below 40 years, 76.7% were overweight or obese, and 38.2% were current or ex-smokers. There were significant associations between PD and both longer duration and increased severity of ED. There were also significant associations between PD and the following socio-demographic risk factors of ED: age, obesity, smoking, duration and number of cigarettes smoked per day. Concomitant diseases and medical comorbidities such as diabetes, dyslipidemia, psychological disorders and the presence of at least one risk factor were significantly associated with PD in patients with ED.

This study offers a quantitative estimate of the prevalence of PD among ED patients in an office-based practice. There were significant associations between ED risk factors and PD.

By Michael J. Metro, MD

Eur Urol. 2006 Mar; 49(3):564-9

El-Sakka AI

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