Abstract and Introduction
Abstract
Peyronie's disease is a chronic condition affecting approximately 3% to 9% of adult males and is associated with significant negative effects on physical and psychosocial well-being and quality of life. Historically, treatment has been limited by a lack of understanding of the pathophysiology. Recent advances have led to the first FDA-approved therapy for the treatment of Peyronie's disease. Evaluation, treatment, and management of patients with this condition, including use of an algorithm and pre-/post-treatment questionnaire, will be discussed.
Introduction
Peyronie's disease (PD) was first noted in 1561 by Fallopius and Vesalius (Filkin & Hog, 1999; Ralph & Pryor, 1999). However, credit for describing the condition is given to Francois Gigot de La Peyronie, a surgeon to Louis XIV of France in 1773 (Peyronie, 1743). Peyronie's disease was first characterized as beads of scar tissue that caused the penis to curve upward during erection (Filkin & Hog, 1999). The symptomatic (i.e., pain, penile curvature interfering with penetration) incidence of PD has been estimated at 1%, and the asymptomatic (i.e., palpable plaque) pre valence is estimated between 0.4% to 1.0% (Carson, Jordan, & Gelbard, 1999; Gelbard, Dorey, & James, 1990; Greenfield & Levine, 2005; Lindsay et al., 1991). A questionnaire-based survey sent to 8,000 males (response rate 55.4%) identified a prevalence of 1.5% in males 30 to 39 years of age, 3.0% in the age groups 40 to 49 years and 50 to 59 years, 4.0% in those 60 to 69 years, and 6.5% in males greater than 70 years of age (Schwarzer et al., 2001). Mulhall and colleagues (2004) noted a prevalence of 8.9% in a population of men presenting for prostate cancer screening. The prevalence may be under-estimated due to a reluctance of men to seek treatment because of embarrassment, lack of awareness of available treatments, or because the patient did not feel the symptoms were disabling enough to justify seeking treatment (DiBenedetti, Nguyen, Zografos, Ziemiecki, & Zhou, 2011). Approximately two-thirds of patients will be between 40 and 60 years, with the youngest reported patient being 15 years and the oldest being 80 years (Chilton, Castle, Westwood, & Pryor, 1982; Poley, 1928; Tal, Hall, Alex, Choi, & Mulhall, 2012).