Abstract: PD31-02
Sources of Funding: AWP is a K12 scholar supported by a Male Reproductive Health Research (MRHR) Career Development Physician-Scientist Award (Grant # HD073917-01) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Program. This work is also supported in part by the Burnett Research Fund. _x000D_

Introduction

Peyronie&[prime]s disease (PD) can cause penile plaque development, resulting in penile deformity and limiting sexual function, and can have a negative psychological impact. Here, we identify predictors of PD risk and progression.

Methods

A retrospective analysis of 212 men with PD presenting to a single academic andrology clinic was performed. Age, date of disease onset, body mass index (BMI), smoking history, erectile dysfunction (ED), hyperlipidemia (HLD), diabetes mellitus (DM), hypertension (HTN) and past and current medications were evaluated. All cases were confirmed with penile ultrasound to quantify plaque size, as well as degree and direction of penile curvature. Linear and logistic regression analysis was used to examine relationships between variables.

Results

Men with PD and ED (ED+PD group) and those with PD alone (PD group) were examined for variables that impact PD development and progression. Of the 212 men with PD, 149 (70.3%) self-reported ED. Furthermore, smoking and HLD were significantly associated with the development of ED in men with PD. Nineteen men were current and 41 were former smokers. The prevalence of ED was 64% in men without HLD but 79% in men with HLD (p=0.018). Logistic regression demonstrated that both HLD and smoking history increased the risk of ED (OR 2.3 and 2.2, 95% CI 1.16-4.47 and 1.14-7.59, respectively). Penile curvature and plaque characteristics did not correlate with the presence of ED, suggesting a vascular etiology for the ED in men in our cohort, rather than one related to fibrosis. In non-smokers, the presence of HLD was associated with a plaque volume that was 151.27 mm³ greater than in men without HLD, adjusting for age, BMI, and duration of PD (p=0.018). History of trauma, age of onset, duration of symptoms and overall plaque volume were not correlated with angle of curvature. When assessing angle of curvature, a 1 cm increase in plaque length correlated with an 8.8 degree increase in curvature.

Conclusions

Hyperlipidemia contributes to increased PD plaque volume and risk of ED, independent of penile curvature or plaque characteristics, suggesting a vascular etiology for ED in some men with PD. These data provide a basis for cardiovascular risk factor modification in affected men. Furthermore, longer penile plaques correlate with more significant penile curvature. These results further facilitate risk stratification and counseling of men with PD. _x000D_

Funding

AWP is a K12 scholar supported by a Male Reproductive Health Research (MRHR) Career Development Physician-Scientist Award (Grant # HD073917-01) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Program. This work is also supported in part by the Burnett Research Fund. _x000D_