Login to Access Video or Poster Abstract: MP56-14
Sources of Funding: None

Introduction

Penile instability (PI) defined as the tendency of the penis to buckle during axial loading is a significant problem for men with PD, as it contributes to difficulty with penetration and leads to increased patient bother and sexual dissatisfaction. Our objective was to investigate the prevalence of PI in men with PD and to evaluate predictors of PI.

Methods

The study population included men with PD, who had a curvature assessment during a rigid erection following an in-office intracavernosal injection. To define PI, axial loading was applied by hand to the glans penis during maximum rigidity. Buckling tendency was recorded as a dichotomous variable. Predictors of PI were determined using multivariable analysis. Parameters evaluated as potential predictors were: degree of curvature, complexity of deformity, direction of curvature, presence of tapering, stretched flaccid penile length.

Results

Mean age of 195 subjects was 55±11 years. 3 evaluators were involved in this analysis. 82% were in a stable relationship and 94% were heterosexual. Mean duration of PD was 16±21 months and mean magnitude of curvature was 39±21 degrees. 15% had hourglass deformity (HGD) and 66% had a unilateral indentation. 48% had instability. On univariate analysis, the following variables were related to PI: degree of curvature (<30°, 31%; 31-59°, 53%; >60°, 75%, p<0.001), presence of an indentation (29% vs. 14%, p=0.02), and presence of dorsal curvature (62% vs. 44%, p=0.01). On multivariable analysis, degree of curvature (OR=3.3, 95% CI 1.9-5.8, p<0.001), presence of an HGD (OR=2.9, 95% CI 1.0-7.9, p=0.04), and a presence of an indentation (OR=3.5, 95% CI 1.5-8.5, p=0.01) were predictors of PI.

Conclusions

PI is very common in men with PD. PI is most likely to occur in men with severe curvature and presence of HGD or indentation.

Funding

None