Subjective and objective analysis of the prevalence of Peyronie's disease in a population of men presenting for prostate cancer screening.

Abstract

In this study we defined the prevalence of Peyronie's disease in a cohort of men being screened for prostate cancer in the United States. The association between Peyronie's disease, and medical comorbidities and patient self-reported erectile dysfunction was also defined. A total of 534 men presenting to 1 of 3 prostate cancer screening centers provided a complete medical history, underwent physical examination performed in all by a urologist and completed the Sexual Health Inventory for Men (SHIM) questionnaire. This population was chosen because of the access to a large number of subjects combined with the fact that subjects were not presenting with a specific urological complaint. The diagnosis of Peyronie's disease was based on a palpable penile plaque. Data were assessed using univariate analysis, multivariate logistic regression and Pearson chi-square analysis. A total of 48 patients were found to have a palpable penile plaque on physical examination for a prevalence rate of 8.9%. The mean age of men with Peyronie's disease was 68.2 years compared to a mean of 61.8 years in men without Peyronie's disease (p <0.0001). On univariate analysis hypertension (p = 0.02) and diabetes (p = 0.007) were present with significantly increased frequency in patients with Peyronie's disease. Patients diagnosed with Peyronie's disease had significantly lower values for responses to each of the 5 questions on the SHIM survey. An increase in age and decrease in total SHIM score remained significantly associated with a greater probability of Peyronie's disease on multivariate analysis. We found the prevalence of Peyronie's disease to be greater than in most previously reported series. We also noted a significant association between Peyronie's disease aging, hypertension, diabetes and self-reported erectile dysfunction.