A Contemporary Assessment of Patients Presenting to a Tertiary Medical Center with Peyronie’s Disease

Abstract

Abstract Peyronie’s disease continues to be poorly understood. We characterize the presenting features of Peyronie’s disease within a large cohort and elucidate the factors that correlate with surgical intervention. Univariate and multivariate analyses were performed on 1483 consecutive patients to assess pre-operative predictors of surgical intervention for Peyronie’s disease. 1263 patients met inclusion criteria. Mean age was 55 ± 11 years with a mean duration of disease at presentation of 33.2 ± 42.5 months. Mean primary curvature was 49.8 ± 20.8°. Primary ventral curvature was present in 11.4% and 36.5% of patient had a multiplanar curvature. During penile duplex ultrasound evaluation indentation/narrowing deformities were appreciated in 76.0%, hourglass deformity in 10.1%, and hinge effect in 33.0% of patients. Calcification was seen in 30.1% of patients. Operative intervention occurred in 35.3% of patients. Severity of primary curvature (1.03 OR, p<0.001), hourglass deformity (1.82 OR, p=0.01), decreased tunical elasticity (1.20 OR, p=0.03), and prior intralesional collagenase clostridium histolyticum injections (2.94 OR, p <0.001) predicted surgical correction. Compared to historical studies, we found a higher incidence of severe degree of curvature, indentation deformities, hinge-effect, multiplanar curvature and penile calcifications. Ultimately, predictors of surgical intervention included those with worse erectile function and more severe characteristics.