BERKELEY, CA (UroToday.com) - There is a lack of consensus on the optimal timing and management of Peyronie’s disease (PD). This stems in large part from our limited understanding of the pathophysiology of the disorder and a dearth of well designed clinical trials of therapy. Poor understanding of PD is widespread even amongst urologists as suggested by a recent study. [1]

Recent research has dramatically increased our knowledge base and offers the potential for newer and more efficacious treatments in the future. Unfortunately, it may be several years before this new information becomes clinically relevant for the general urologist in practice.

The purpose of this study was to determine how urologists in clinical practice are actually managing Peyronie’s disease. We found that vitamin E was by far the most prescribed oral therapy (selected by 70% of respondents) compared to the second most commonly utilized oral therapy (Potaba®, chosen by 20%). Just over half of urologists surveyed performed surgery for Peyronie’s disease, and 85% of these performed just 1-5 procedures per year. This suggests that very few urologists are “high-volume” Peyronie’s surgeons.

With respect to management of our case presentations, the majority of urologists favored observation and medical therapy for all patient presentations except for the case of severe curvature associated with ED, for which surgical management was most popular.

It was unfortunate that our response rate was low and this obligates us to take our findings with the proverbial “grain of salt” with respect to their generalizability to the larger body of U.S. urologists. Nevertheless, our study suggests that current management of PD amongst urologists is based more or less on the best available evidence with medical therapy the treatment of choice for mild disease or disease in its’ active state and surgical intervention usually reserved for patients with severe, chronic phase disease. It is our hope that research in PD will continue and in the future management of the patient with PD will be based on what is most universally effective rather than on provider preference.

1. LaRochelle JC, Levine LA. A Survey of primary-care physicians and urologists regarding Peyronie's disease. J Sex Med. 2007 Jul;4(4 Pt 2):1167-73

Written by
Alan W. Shindel MD, as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.

Urologist Practice Patterns in the Management of Peyronie's Disease: A Nationwide SurveyUrologist Practice Patterns in the Management of Peyronie's Disease: A Nationwide Survey - Abstract

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