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


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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    • "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 . "
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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.
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