Article

Predicting Delay in Presentation in Men with Peyronie's Disease

Memorial Sloan-Kettering Cancer Center, Urology, New York, NY 10021, USA.
Journal of Sexual Medicine (Impact Factor: 3.15). 06/2010; 7(6):2226-30. DOI: 10.1111/j.1743-6109.2010.01785.x
Source: PubMed

ABSTRACT Many men with Peyronie's disease (PD) delay presentation to a urologist. The reasons for this are unclear.
To define the differences in men who present early compared to those presenting in a delayed fashion and to determine predictors of delayed presentation.
A retrospective analysis of all patients presenting for the first medical evaluation of PD. All patients underwent a standard history and physical examination and had a standardized deformity assessment. Demographic and PD parameters were recorded.
Statistical comparison was used to define factors that were different between early and delayed presenters and multivariable analysis was used to define predictors of presentation >12 months.
482 patients were analyzed, 61% presenting ≤12 months, 39% >12 months. Mean patient age was 52 ± 13 years and mean duration of PD was 17 ± 30 months. Mean measured curvature was 42° ± 19°. Multivariable analysis revealed that delayed presentation patients were significantly more likely to be older (odds ratio [OR] = 4.0), to be in long-term relationships (OR = 3.6), to have dorsal curvature (OR = 2.5), to have curvature <45° (OR = 3.3), to be heterosexual (OR = 2.0), and to have simple deformity (OR = 1.5).
One-third of men with PD presented in a delayed fashion and they tended to be older, to be in long-term relationships, to have dorsal curvature, or to have simple deformity.

0 Followers
 · 
99 Views
 · 
0 Downloads
  • Source
    • "Many patients may be reluctant to come to their physician for treatment and diagnosis of this embarrassing condition [25]. Several factors have been identified that predict which patients are more inclined to delay treatment, including older age, being in a long-term relationship, having a partner, being heterosexual, and the presence of simple penile deformity [35]. Of those seeking medical treatment for penile symptoms, most initially saw a PCP, and the average duration of time to a doctor visit was within a year and a half of noticing a penile symptom . "
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose. To estimate the US prevalence of Peyronie's disease (PD) from patient-reported data and to identify diagnosis and treatment patterns. Methods. 11,420 US males ≥18 years old completed a brief web-based survey regarding the presence of PD, past treatments, and penile symptoms (Phase 1). Phase 1 respondents with PD diagnosis, history of treatment, or PD-related symptoms then completed a disease-specific survey (Phase 2). Results. Estimated prevalence of PD ranged from 0.5% (diagnosis of PD) to 13% (diagnosis, treatment, or penile symptoms). Thirty-six percent of Phase 2 participants reported that penile symptoms interfered with sexual activities. Of participants who sought treatment for penile symptoms (n = 128), 73% initially saw a primary care physician, 74% did not receive treatment from their first doctor, and 92% were not diagnosed with PD. Conclusions. PD may be underdiagnosed/undertreated in the US. Improved awareness is needed of PD symptoms and treatment options among health care professionals.
    Advances in Urology 10/2011; 2011(1687-6369):282503. DOI:10.1155/2011/282503
  • [Show abstract] [Hide abstract]
    ABSTRACT: INTRODUCTION: Peyronie's disease (PD) is an acquired benign connective tissue disorder of the penis, characterized by the development of fibrotic plaques, that can cause different degrees of bending, narrowing or shortening. Medical treatment for PD remains a major challenge. Impressive progress in our understanding of the molecular mechanisms of PD pathogenesis has uncovered several promising molecular targets for antifibrotic treatments. AREAS COVERED: This review covers the literature pertaining to the exploration of therapeutic targets for PD. The search included: i) a MEDLINE search from 1941 to January 2011, limited to English-language medical literature, ii) relevant abstracts from 2009 and 2010, iii) relevant textbooks and iv) a pipeline search for therapeutics in development. EXPERT OPINION: Rapid translational research depends on our ability to develop rational therapies targeted to penile tunical fibrosis, which necessitate a sound knowledge of the biology, biochemistry and the physiological role of fibroblasts, myofibroblasts and stem cells in PD. Much remains to be learned about the pathogenesis of PD. Although there are many interesting therapeutic targets, we are confronted with some questions when identifying new targets, or when validating potential therapeutic options.
    Expert Opinion on Therapeutic Targets 04/2011; 15(8):913-29. DOI:10.1517/14728222.2011.577419 · 4.90 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Peyronie’s disease is a common potency-threatening condition of male sexual dysfunction, occurring in 3–8% of men. While typically thought to be a result of injury during sexual activity, the underlying cause of Peyronie’s disease can vary and is not known in every situation. Clinical presentation may include a curved or bent penis, a palpable penile scar or plaque, complaints of decreased penile length, diminished penile stretch, less rigidity, penile numbness, and erectile dysfunction. Numerous advances have been made in understanding the mechanisms involving Peyronie’s disease, while improved diagnostic techniques, including penile duplex Doppler ultrasonography, and advanced therapeutic interventions, including intralesional therapy, surgical grafting techniques, and advanced prosthetics have allowed for the successful treatment of this significant medical problem. This chapter reviews the contemporary state of knowledge of Peyronie’s disease, focusing on the role of diagnostics, therapeutic alternatives and offers an algorithmic approach for the management of this disorder.
    Urological Men’s Health, 01/2012: pages 97-103; , ISBN: 978-1-61779-899-3
Show more