Abstract: PD31-03
Sources of Funding: None

Introduction

In 2015 the American Urological Association (AUA) released guidelines on the management of Peyronie&[prime]s Disease (PD). We sought to characterize the surgical therapies being utilized for the management of PD in New York State prior to the release of the AUA guidelines.

Methods

The New York Statewide Planning and Research Cooperative System (SPARCS) database was queried for men undergoing surgery for Peyronie&[prime]s Disease from 2003 to 2014. Patients were identified using ICD-9-CM diagnosis codes for PD (60785). Surgical intervention was determined using ICD-9-CM and CPT codes. Patient demographics and comorbidities were recorded and treatment strategy was stratified by erectile dysfunction status.

Results

A total of 1,655 men underwent surgery for Peyronie&[prime]s Disease, corresponding to a rate of 1.9 cases per 100,000 person-years. Of the 1,655 men treated surgically for PD, 69.7% had concomitant ED. 97% (1124/1154) of these men underwent inflatable penile prosthesis (IPP) placement. Amongst men with PD who underwent IPP, 56.7% (637/1124) were treated with a concomitant straightening procedure. The use of plaque excision or incision and grafting (PEG/PIG) at the time of IPP was rare (45/1124, 4.0%), indicating that 96% of adjunctive maneuvers used to achieve straightening were either penile modeling or tunical plications. In men with PD without ED, 7% (35/501) underwent IPP placement with the remainder of procedures split almost evenly between tunical plication (235/501, 46.9%) and PEG/PIG (231/501, 46.1%). Only 2.8% (13/466) of men with PD treated with non-implant surgery went on to have an IPP.

Conclusions

This is the first published description of PD surgical practice patterns derived from a large, population-based dataset. 70% of men that underwent surgery for PD in New York had concomitant ED and received an IPP. In the vast majority of these cases, complex reconstructive procedures using grafting was not required. Patients with PD without ED were usually treated with non-implant procedures, and these men only rarely went on to receive an IPP.

Funding

None