An Analysis of Case Logs From American Urologists in the Treatment of Peyronie's Disease

To review recent trends in the treatment of PD, we assess surgical practice patterns of urologists in the United States with emphasis on specialty training, demographics, and temporal changes.

Six month case log data of American urologists between 2004 and 2013 was obtained from the American Board of Urology.

CPT codes were used to identify surgical procedures, including plaque injection.

A total of 6,564 urologists were included in the surgical cohort logging 8,195 surgical procedures for PD. Only 15. 4% (1012/6564) of urologists reported a surgical case for PD. Andrologists (urologist subspecialty designation) accounted for 5. 3% (54/1012) of these urologists and performed 18. 5% of PD procedures (p=0. 0001). The frequency of plaque injections increased from 499 in 2004 to 797 in 2013, a 59% increase, while surgical correction remained stable. Urologists performed four-times as many injections as surgical procedures for PD (p=0. 001) with andrologists more likely to attempt injection than surgical correction (p=0. 045). Among surgeries performed, 73. 2% were corrections of angulation without plaque excision, 20. 5% were excisions of plaque (with possible grafting) up to 5 cm, and 6. 2% were excisions of plaque (with possible grafting) greater than 5 cm. There was a 313% increase in the ratio of plication to plaque manipulation (0. 92 in 2004 to 2. 91 in 2013).

Peyronie's disease is treated by a minority of urologists and disproportionately by sub-specialist in andrology. When compared to surgical interventions, excluding prosthesis implantation, most surgeons favor conservative treatment. The majority of surgical corrections were corrections of angulation without plaque manipulation.

Urology. 2015 Oct 19 [Epub ahead of print]

Daniel T Oberlin, Joceline S Liu, Matthias D Hofer, Jaclyn Milose, Richard S Matulewicz, Sarah C Flury, Allen F Morey, Chris M Gonzalez

Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL. Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL. , Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL. , Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL. , Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL. , Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL. , Department of Urology, University of Texas Southwestern, Dallas, TX. , Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL.

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