Peyronie's Disease Plaque Calcification—Prevalence, Time to Identification, and Development of a New Grading Classification

Abstract

Introduction Peyronie's disease (PD) is a connective tissue disorder of the penis in which a fibrous scar in the tunica albuginea can result in multiple penile deformities. Aim The study aims to investigate the prevalence and time to identification of plaque calcification (PC) in our PD patient population and whether stratification of calcification based on severity seen on ultrasound would serve as a predictor of treatment progression to surgery. Methods A retrospective review of 1,041 men presenting with PD from 1993 to 2009 was performed. Eight hundred thirty-four underwent penile duplex ultrasound. Main Outcome Measures PC was graded as: grade 1 (<0.3 cm), grade 2 (>0.3 cm, <1.5 cm), grade 3 (>1.5 cm; or ≥2 plaques >1.0 cm). A matched control group with noncalcified plaques (n = 236) was selected for comparison. Results Two hundred eighty-four men (34%) were found to have PC noted on ultrasound, and 98 had fully documented dimensions of the PC. Forty-one percent were found to have grade 1, 28% grade 2, and 32% grade 3. When analyzed by grade and progression to surgery, 23% of grade 1, 32% of grade 2, and 55% of grade 3 patients had surgery. Those with grade 3 PC were more likely to undergo surgical intervention for PD (OR 2.28 95% CI 1.07–4.86) and more likely to undergo a grafting procedure than control patients (P < 0.0001). Conclusions Men with PC are not more likely to undergo surgery than those without PC (OR 0.95, 95% CI 0.58–1.57). PC is not uncommon, as it was found in 34% of our cohort. PC does not appear to be an indication of mature or stable disease, as it was identified by ultrasound in 37% of patients less than 12 months after onset of symptoms. Men with grade 3 PC have an increased likelihood of progression to surgical intervention and a higher likelihood of undergoing a grafting procedure.

Topical treatment for acute phase Peyronie’s disease utilizing a new gel, H-100: a randomized, prospective, placebo-controlled pilot study

“…Plaque calcification was graded as 0 = no calcification, 1 = o3 mm calcification, 2 = 3-15 mm calcification, 3 = 415 mm or 2 plaques each with 410 mm calcification. 8 Participants were included if their calcium grade was 0 or 1.…”

The role of inflammatory parameters (neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio, and monocyte‐to‐eosinophil ratio) in patients with Peyronie's disease

“…In the acute phase of the disease, penile pain during erection usually presents as a chief complaint. Furthermore, penile plaque and progressive penile curvature are observed in the active phase of the disease (Levine et al, 2013;Brimley et al, 2019). The acute phase generally ends after 5-7 months.…”

Evaluation of the benefit of using a combination of autologous platelet rich-plasma and hyaluronic acid for the treatment of Peyronie’s disease

“…PRP rich in growth factors and other compounds initiates a reconstructive process in TA, whose global effects are visible through echographic controls. Although widely used for diagnostic purpose [24,25], US technique is very specific to this proposed technique of treatment with two advantages. First, it allows taking precise measurements of the whole albuginea, providing comparison data all along the procedure.…”