Predicting Delay in Presentation in Men with Peyronie's Disease
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.
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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
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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
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ABSTRACT: Objective Male genital image has a significant impact on sexual functioning and quality of life. This concept will be defined, and attempts to operationalize and measure it will be critiqued. Selected medical conditions and surgical treatments that impact male genital image will be highlighted, and discussed. Method A PubMed review of genital image measurement was performed, along with a review of selected medical conditions and surgeries that affect the appearance and functioning of the male genitals including micro-penis, hypospadias, Peyronie's disease, and genital cancers. Results Male genital image does appear to be a measurable attribute, and is correlated with a number of sexual health outcomes. Present measurement methods, however, may only apply to healthy populations. Furthermore, medical conditions affecting the appearance and functioning of the genitals appear to have significant impact on genital image as well as on quality of life. Discussion Male genital image should be taken into account when considering medical interventions affecting the genitalia. Better measures of genital image need to be developed and validated; this will allow for better understanding of the psychosexual outcomes of genital image, as well as for examining how genital image can be improved.Sexologies 04/2012; 21(2):43–47. DOI:10.1016/j.sexol.2011.11.001