Peyronie’s Disease in Teenagers

Abstract

Introduction Peyronie’s disease (PD) is commonly seen in middle-aged men, and little is known about this condition in teenagers. Aim To investigate the characteristics of PD in teenagers. Methods The findings were compared between patients with the disease who were teenagers with those over 40 years of age. Statistical analyses were conducted to define differentiating features between these two groups. Main Outcome Measures The demographics, clinical features, and associated comorbidities of patients with PD were reviewed. Results Thirty-two teenaged males were evaluated for PD in a single institution over a 10-year period. The median age for our cohort was 18 (15–19) years. Forty-five percent of patients had already been seen by another urologist, and 28% had been told they did not have PD. The mean duration of PD before seeking medical care in our cohort was 3 ± 1 months. Sixteen percent of patients reported antecedent penile trauma, half of which happened during coitus or masturbation, and 18% of patients had hemoglobin (Hb) A1c levels > 5%. Dupuytren’s contracture was not seen in this population. Twenty-two percent of patients presented with penile pain. Subsequent ED was seen in 37% of patients. Multiple noncontiguous plaques were seen in 37% of patients. Twelve percent were previously treated with vitamin E, while another 12% had previous intralesional verapamil. High distress was reported by 94% of patients. Thirty-four percent sought medical attention for anxiety/mood disorder, and 28% had a negative encounter with a sexual partner related to PD. All of the 32 patients had penile curvature with a mean of 32 ± 12 degrees. Seventy-two percent of the patients had dorsal curvature while 22% had an associated deformity. Using duplex Doppler ultrasound, 12% had a calcified plaque, while none of the patients had abnormal hemodynamics. When compared with PD in adults, teenagers had greater than seven times the prevalence of multiple noncontiguous plaques (37% vs. 5%). Also, the prevalence of HbA1c level > 5% was higher in the teenagers as well (18% vs. 5%). Conclusions PD does occur in teenagers often causing high distress levels. Compared to older adults, teenagers often present earlier, and more commonly have elevated HbA1c level and increased number of plaques at presentation.

Baseline Characteristics from an Ongoing Phase 3 Study of Collagenase Clostridium Histolyticum in Patients with Peyronie's Disease

“…Several studies have reported about 5% to 10% of patients present with PD who are <40 years of age [32–34]. A recent study has demonstrated that PD can also occur in a teenage patient population, and it is generally associated with high levels of distress in this population [35]. It is conceivable that future studies may need to consider age as a variable when examining PD symptoms such as bother and distress.…”

The Genetic Basis of Peyronie Disease: A Review

“…17, 18 Despite the higher incidence in older men, PD can affect men of all ages, from teenagers to men over 70 years old. 19–21 Reported prevalence rates of PD range from 0.4% to 13%, although these are likely underestimates due to an under-reporting bias; men are often reluctant to discuss this condition. 21, 22 …”

The Impact of Peyronie's Disease on the Patient: Gaps in Our Current Understanding

“…The potential importance of testosterone deficiency, hypertension, dyslipidemia, and diabetes mellitus is indicated by preliminary studies suggesting an association between these conditions and increased risk for or severity of Peyronie's disease (Cavallini, Biagiotti, & Lo Giudice, 2012;El-Sakka, 2006;El-Sakka et al, 2005;Kadioglu et al, 2002;Nam, Park, & Park, 2011;Rhoden, Riedner, Fuchs, Ribeiro, & Halmenschlager, 2010;Tal et al, 2012;Tefekli, Kandirali, Erol, Tunc, & Kadioglu, 2006). The potential importance of testosterone deficiency, hypertension, dyslipidemia, and diabetes mellitus is indicated by preliminary studies suggesting an association between these conditions and increased risk for or severity of Peyronie's disease (Cavallini, Biagiotti, & Lo Giudice, 2012;El-Sakka, 2006;El-Sakka et al, 2005;Kadioglu et al, 2002;Nam, Park, & Park, 2011;Rhoden, Riedner, Fuchs, Ribeiro, & Halmenschlager, 2010;Tal et al, 2012;Tefekli, Kandirali, Erol, Tunc, & Kadioglu, 2006).…”