Abstract: PD31-01
Sources of Funding: None

Introduction

Relatively limited data exist on the natural history of untreated Peyronie’s Disease (PD). Here, we sought to evaluate and report on the natural history of patient-reported changes in penile curvature, pain, and shortening in men with untreated PD.

Methods

We identified all patients who underwent evaluation for PD at our institution between 1990 and 2012. 719 patients were randomly selected to receive a mail-in questionnaire with questions relating to the natural history of PD, including topics of change in curvature, pain, and shortening over time. Results were subsequently summarized as a descriptive report, and statistical comparisons were performed where appropriate.

Results

A total of 162 patients (23% response rate) completed the mail-in survey. Of these, 125 had no history of prior intralesional or surgical therapy for PD, and these patients comprised our study cohort. Median (IQR) patient age at diagnosis was 65 (62;68), and PD duration was 8.4 (5;12) years. Eighty-six percent of patients presented with penile curvature including 46% dorsal/ventral and 54% lateral, per patient report. Twelve percent of patients reported multi-planar curvature and 84% estimated their curvature as < 45 degrees. Penile curvature resolved in 16%, improved in 27%, worsened in 20%, and remained stable in 37% of patients. Interestingly, 12% of patients developed a new penile curvature at a median (IQR) of 17 (11;39) months after initial presentation, and these patients were significantly more likely to report worsening of their initial penile curvature (p=0.01). Fifty-four percent of patients reported penile indentation or narrowing. Penile pain was reported in 60% of patients, of whom the pain improved (18%) or resolved (64%) at a median (IQR) of 12 (6;24) months. Sixty-five percent of patients reported penile shortening, with 30% noting progressive shortening over time.

Conclusions

The current report provides additional understanding on the natural history of untreated PD. Contrary to some reports, the majority of men note curvature stability or improvement, resolution of pain, and progressive penile shortening over time. Only 20% reported worsening of curvature after disease stability, with 12% developing de novo curvature. This information significantly enhances our understanding and provides data for counseling patients with newly diagnosed PD.

Funding

None