INVESTIGATIVE UROLOGY

Prevalence of Peyronie’s Disease among Patients with Erectile Dysfunction
El-Sakka AI
Department of Urology, Suez Canal University, School of Medicine Ismailia, Egypt and Al-Noor Specialist Hospital, Makkah, Saudi Arabia
Eur Urol. 2006; 49: 564-9

• Purpose: To assess the prevalence of Peyronie’s disease (PD) among patients with erectile dysfunction (ED).
• Materials and Methods: A total of 1,440 male patients with ED were enrolled in this study. Patients were interviewed for ED using the International Index of Erectile Function (IIEF). All patients were also screened for socio-demographic data and risk factors for ED that included age, smoking, diabetes, hypertension, dyslipidemia, Ischemic Heart Disease (IHD), and psychological disorders. The diagnosis of PD was based on a palpable penile plaque or acquired penile curvature. Patients underwent routine laboratory investigation in addition to testosterone and prolactin assessment.
• Results: Mean ages +/-SD were 54.1 +/- 6.9 (range 42-71) and 52.5 +/- 11.9 (range 20-84) years for patients with and without PD respectively. Of the patients, 11.8% had mild, 38.3% had moderate and 49.9% had severe ED. 7.9% of the patients had PD. Significant associations between PD and both the longer duration and the increased severity of ED were detected. There were also significant associations between PD and the following socio-demographic risk factors of ED: age, obesity, smoking, duration and number of cigarettes smoked per day. Concomitant diseases and medical comorbidities such as diabetes, dyslipidemia, psychological disorders and the presence of at least one risk factor were significantly associated with PD in patients with ED.
• Conclusions: Peyronie’s disease was not rare among the study population. There were significant associations between ED risk factors and PD. Further studies are needed to investigate how much ED and PD influence each other.
  
  
• Editorial Comment
  This is an interesting paper studying the incidence of Peyronie’s disease (PD) and erectile dysfunction (ED). Peyronie’s disease affects up to 9% of male adult population (1) and the present findings are not so much different form the general data.
  Other recent study (2) investigated the erectile function status of men presenting with Peyronie’s disease. Demographics of patients regarding age, duration of PD, nature of deformity and comorbidities were compared between the patients with PD, with and without erectile dysfunction. 35% of the patients had had ED. The mean age of patients with PD and ED was 52 +/- 22 years old. Hypertension (71.5%), hyperlipidemia (60.4%) and smoking (49.2%) were the leading comorbidities, which are also similar to those found by El-Sakka.
  An interesting recent study using penile ultrasound color Doppler (USCD) for assessing ED, detected in 8.7% of the patients, with no clinical symptoms or any clinical findings, minimal lesions suggestive of Peyronie’s disease (3).
  In spite of further studies to investigate how much ED and PD influence each other, the association is clear, and, therefore, treatment algorithms for men with combined Peyronie’s disease and erectile dysfunction must be defined based on functional and satisfaction outcomes (4).

References
1. Gonzalez-Cadavid NF, Rajfer J: Mechanisms of disease: new insights into the cellular and molecular pathology of Peyronie’s disease. Nat Clin Pract Urol. 2005; 2: 291-7.
2. Deveci S, Palese M, Parker M, Guhring P, Mulhall JP: Erectile function profiles in men with Peyronie’s disease. J Urol. 2006; 175: 1807-11; discussion 1811.
3. Mander A, Palleschi G, Gentile V, Gezeroglou H, Dornbusch T, Pastore AL, Carbone A: Early echographical assessment of minimal lesions of cavernosum corpora and tunica albuginea in subjects with erectile dysfunction, suggestive of La Peyronie’s disease. Int J Impot Res. 2006 Mar 9; [Epub ahead of print].
4. Mulhall J, Anderson M, Parker M: A surgical algorithm for men with combined Peyronie’s disease and erectile dysfunction: functional and satisfaction outcomes. J Sex Med. 2005; 2: 132-8.

Dr. Francisco Sampaio
Full-Professor and Chair, Urogenital Research Unit
State University of Rio de Janeiro
Rio de Janeiro, Brazil