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abstract

abstract

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Comparing plaque morphology between men developing Peyronie’s Disease (PD) after radical prostatectomy (RP) to that of de novo Peyronie’s Disease patients

Sullivan, J1Bernie, H 1; Ortega, Y1; Chiles, K2; Jenkins, L3; Mulhall, J1

1: Memorial Sloan Kettering Cancer Center, United States; 2: George Washington University; 3: The Ohio State University

Objectives: Increasing awareness now exists of the association between RP and development of PD. Yet, little is known about how RP-associated PD (RPD) differs from de novo PD (DPD). This study was undertaken to compare patient and plaque characteristics between men with RPD and DPD.

Materials and Methods: Consecutive patients developing RPD within 2 years of their operation and patients with DPD had demographic, comorbidity, and PD characteristics recorded. All patients had an in-office curvature assessment and a penile duplex Doppler ultrasound (PDDU) following injection of an intracavernosal vasoactive agent to achieve penile rigidity. Particular attention was paid to plaque morphology as defined by an experienced sexual medicine physician. Plaque morphology was defined according to the following classification system: linear, full length, linear partial length, plate-like, septal. ‘Bilateral’ plaques (dorsal plus ventral) and calcification status (defined on ultrasound) were also recorded.

Results: 377 men with RPD and 737 consecutive DPD patients enrolled over the same time period were studied. Mean age: RPD 64±12 vs DPD 54±16 years (p<0.01). Diabetes prevalence: 4% vs 7% (p<0.05). There were no differences in: race (87% overall Caucasian), mean early morning serum total T levels (overall 469 ng/dl), degree of curvature (38±10 degrees), direction of primary curvature (67% dorsal), presence of plate-like calcification (14%), presence of septal plaque (2%) and erectile hemodynamics (88% normal). Overt differences in plaque morphology are presented in the table.
Conclusion:
Men developing PD after RP have ethnic and comorbidity profiles similar to those of men developing PD de novo. RPD patients are more likely to have full-length linear plaques, to have concomitant dorsal and ventral plaques, and less likely to have a plate-like plaque.

 

RPD

DPD

P Value

Linear, full length (%)

72

30

<0.01

Linear, partial length (%)

11

31

<0.01

Plate-like (%)

16

39

<0.01

Presence of ‘bilateral’ plaques (%)

29

14

<0.01

Disclosure:

Work supported by industry: no.

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