Abstract: PD31-04
Sources of Funding: PB was supported by The Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust.

Introduction

The incidence of Peyronie&[prime]s disease (PD) after treatment of prostate cancer (PCa) has been estimated to be as high as 16% in the three years after radical prostatectomy (RP). Despite its high prevalence in the post-RP, PD-screened population, the prevalence amongst all PCa patients is unknown. We hypothesized that PD incidence is generally under-diagnosed in men with PCa and that incidence rates vary based on PCa treatment.

Methods

We analyzed subjects contained within the Truven Health MarketScan claims database from 2007-2014. This US database provides information of insurance claims filed for the care of privately-insured individuals with employment-based insurance through a participating employer. Men with PCa were identified and stratified based on their treatment modality: RP, radiation (XRT), chemotherapy and RP (C-RP), chemotherapy alone (C) or no treatment (N). Men were followed both from entry in the cohort as well as from diagnosis of PCa after prostate biopsy. The cohort of men was followed longitudinally and assessed for subsequent new diagnoses of PD occurring at least one day after PCa treatment. Both PD incidence and timing of PD onset were analyzed and compared between the five PCa treatment modalities.

Results

140,595 men with PCa were identified, of which 60,749 (43%) underwent RP, 31,499 (22%) XRT, 7,216 (5%) C-RP, 18,083 (13%) C, and 37,658 (27%) N. Average age and follow-up were 58 years and 3.5 years, respectively. Overall, new-onset PD was identified in 912 men (0.65%). The incidence of PD was highest in the RP and C-RP groups when compared to the XRT, C and N groups (Table). The onset of PD appeared to be quicker in RP patients compared to XRT, though the difference was not statistically significant. Among younger men (<60y) who may have better erectile function, be more sexually active, and therefore be more sensitive to detecting penile deformities, PD occurred quicker in RP vs XRT patients (1.4 vs 2.0 years)

Conclusions

These PD incidence figures are dramatically lower than other published data, suggesting there is an under-appreciation of PD as a sequela of PCa treatment amongst patients and practitioners. PD appears to occur more commonly and rapidly after RP compared to XRT. Given that early treatment may alter the course of PD, additional research is warranted to understand these findings.

Funding

PB was supported by The Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust.