Comparative analysis of the natural history of de novo Peyronie’s Disease versus post-radical prostatectomy Peyronie’s Disease
Sullivan, J1; Bernie, H1; Ortega, Y1; Mulhall, J1
1: Memorial Sloan Kettering Cancer Center, United States
Objectives: It has been estimated that the minority of men with PD when left untreated and followed for at least a year after condition onset improve their deformity and that approximately half of them will worsen their deformity over the same period. PD appears to be associated with RP. Little is understood about how RP-associated PD (RPD) differs from de novo PD (DPD). This study was undertaken to compare the natural history of this condition between men with RPD and DPD.
Materials and Methods: Consecutive patients developing RPD within 2 years of their operation and patients with DPD who opted to not pursue any treatment had demographic, comorbidity, and PD characteristics recorded. All patients had an in-office curvature assessment (CA) and a penile duplex Doppler ultrasound (PDDU) at baseline and a repeat CA at least 12 months after being initially evaluated.
Results: 146 men with RPD and 246 men with DPD were included for analysis. Mean age was RPD 62±16 vs 52±22 years (p<0.01). Mean time of repeat CA was: RPD 17±4 months vs DPD 18±7 months. Diabetes was less common in the RPD group 4% vs 8% (p<0.01). Mean degree of curvature: 42±22 degrees vs 40±18 degrees (p=0.76) Stretched flaccid length (SFPL) at baseline was: RPD 10.4±1.6 cms vs DPD 11.4±1.2 cms (p<0.01). The proportion of men, who remained stable, worsened and improved over ≥12 months were (RPD vs DPD): 43% vs 40; 12% vs 18%; 48% vs 39% (all non-statistically significant).
Conclusions: There was no clear difference in the natural history of PD in men after radical prostatectomy compared to men with de novo PD. RPD patients were more likely to have shorter SFPL and a lower incidence of diabetes.
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