Prevalence, Risk Factors, and Erectile Dysfunction Associated With Peyronie’s Disease Among Men Seeking Urological Care

Abstract

Introduction: Peyronie's disease (PD) is a connective tissue disorder of the penis characterized by an abnormality in collagen structure of penile tunica albuginea. Aim: We sought to investigate the prevalence, risk factors, and the relationship between erectile dysfunction (ED) and PD in male patients aged 30e80 years seeking urological care. Methods: This is a cross-sectional study using data collected from October 2016 to October 2017 in an outpatient clinic associated with the Brazilian Public Health System. All men aged 30 to 80 years were invited to participate. Data collected were related to the clinical history and sexual habits of patients using the International Index of Erectile Function, in addition to the physical examination of the penis and laboratory parameters. Main Outcome Measure: Descriptive statistics and multivariate logistic regression models tested the prevalence, risk factors, and the relationship between ED and PD in male patients. Results: The study included 656 individuals, who were distributed as per age, marital status, race, educational level, and income. Of these participants, 86 (13.11%) presented with fibrous plaques compatible with PD at the physical examination. Among the risk factors evaluated, PD was associated with diabetes, smoking, and obesity in 43.02, 64.17, and 26.74% of patients, respectively. The presence of penile plaques compatible with PD was more prevalent in men with ED, history of penile trauma, and complaint of penile deformity. There was a higher prevalence of plaques in the distal penis. Conclusion: The PD among the studied population was associated with risk factors such as diabetes, smoking, and obesity. Other clinical characteristics, such as history of penile trauma, penile deformity, and ED, were reported in patients with PD. There was a higher prevalence of plaques in the distal penis, specifically in the corona of the glans penis. The prevalence of PD was different from that in the published literature, our results show that numbers thus more studies are needed.

The relationship between testosterone levels and Peyronie’s disease

“…(2002) emphasised that ED is a risk factor for PD in a large retrospective study. An other current study showed that PD is related with mild to moderate level ED (Segundo & Glina, 2020). Although it seems a suitable link between low serum testosterone levels and erectile dysfunction, aetiology of ED may be multifactorial such as vascular problems, habits and smoking.…”

“…Prevalence of PD varies depending on population and geographic region. The prevalence rates range from 0.39% to 22.5% (Segundo & Glina, 2020; Sharma, Alom, & Trost, 2019). Generally, patients in the range of 45–60 years are affected from PD.…”

Low-intensity extracorporeal shock wave therapy for Peyronie's disease

“…This phenomenon is called cavitation. 23 An inflammatory reaction causes plaque lysis, resorption of calcifications, and their removal by macrophages. Heat-induced increased vascularity and decreased packing and clumping of collagen fibers within the plaques have been observed after ESWT.…”

Fibroproliferative disorders and diabetes: Understanding the pathophysiologic relationship between Peyronie’s disease, Dupuytren disease and diabetes

“…The fibrotic plaques of Peyronie's disease can cause several abnormalities of the penis (eg curvature, shortening and narrowing), which can result in penile pain 13 . Risk factors for Peyronie's disease include penile trauma, smoking, obesity and hypertension 14‐16 . Several studies have suggested a relationship between Peyronie's disease and diabetes (Table 1, Peyronie's disease) 14,17,18 .…”

“…13 Risk factors for Peyronie's disease include penile trauma, smoking, obesity and hypertension. [14][15][16] Several studies have suggested a relationship between Peyronie's disease and diabetes (Table 1, Peyronie's disease). 14,17,18 In addition, a 2019 Iranian study reported a prevalence of Peyronie's disease of 3.8% among 317 men with type 2 diabetes.…”