There are some data suggesting that there is a relationship between the magnitude of Peyronie's disease (PD)-associated penile curvature and low serum testosterone.
To evaluate the relationship between PD associated penile deformity and total testosterone (TT) and free testosterone (FT) levels.
We identified patients diagnosed with PD who had early morning TT measurements. Because laboratories have different reference values, we analyzed testosterone values 2 ways, as raw values and as standardized values (TT and FT values converted into z-scores for each laboratory). Deformity assessment was conducted during an intracavernosal injection-induced rigid erection. The association between T levels and magnitude of penile curvature was analyzed in a number of ways. First, an independent measure t-test tested differences in curvature degree by TT groups (low T: <300 ng/dL; normal T: ≥300 ng/dL). Second, an association was sought between T levels based on quartiles of the normal range (<300, 300-450, 450-600, and >600 ng/dL). These analyses were conducted for both TT and FT levels and using both raw and standardized T values. Third, multivariable analysis using multiple linear regression was performed in an attempt to define predictors of the degree of penile curvature. Factors entered into the model included: TT level, FT level, patient age, race (white vs other), number of co-morbidities, body mass index, presence of erectile dysfunction, duration of PD, and prostatectomy (yes vs no).
The relationship between T levels and the magnitude of penile curvature.
184 subjects met all study criteria. Average age was 54 ± 12 years. Mean TT level was 425 ± 176 ng/dL, and mean curvature magnitude was 35° ± 19°. The percent of subjects in the first through fourth TT quartiles was 26%, 34%, 24%, and 16%. As a continuous variable, there was no association between TT levels (r = -0.01, P = .95) or FT levels (r = -0.08, P = .30) and the curvature magnitude. When examining TT groups, there was no difference in mean curvature between the low TT group and the normal TT group (35.4° ± 17° vs 34° ± 20°, P = .70). When analyzing the TT and FT levels standardized into z-scores, there was no association between degree of curvature and TT z-scores (r = -0.003, P = .95) and FT z-scores (r = -0.08, P = .43). There was also no association between testosterone levels and degree of curvature in the multivariable model.
There does not appear to be any association between testosterone levels and the magnitude of PD-associated penile deformity. Mulhall JP, Matsushita K, Nelson CJ. Testosterone Levels Are Not Associated With Magnitude of Deformity in Men With Peyronie's Disease. J Sex Med 2019;XX:XXX-XXX.
The journal of sexual medicine. 2019 Jul 11 [Epub ahead of print]
John P Mulhall, Kazuhito Matsushita, Christian J Nelson
Sexual & Reproductive Medicine Program, Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. Electronic address: ., Sexual & Reproductive Medicine Program, Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA; Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan., Departments of Psychiatry/Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.