Treatment Satisfaction of Peyronie's Disease Patients at a Teaching Hospital

Author(s): Camila Klotz, Lívia Fratelli, Bruno Hideo Nishi, Lilian Castiglioni, Luis Cesar Fava Spessoto, Fernando Nestor Facio Junior

Background: The penis can be affected by several pathologies, including Peyronie's Disease (PD), a condition characterized by structural alterations caused by disorders that occur during tunica albuginea healing. Several clinical treatment options exist for the management of this pathology, however the benefits of many have not been proven scientifically. The objective of this study was to investigate the management and follow-up of Peyronie's disease patients in order to identify the treatments provided and the respective degrees of patient satisfaction. Over 18-year-old male patients with early onset Peyronie's disease (less than three months) treated at an outpatient urological clinic between 2015 and 2020 were retrospectively studied. Results: The most commonly used treatment was the combination of pentoxifylline, vitamin E and colchicine (44%). There is evidence of a significant association between the type of clinical treatment used and the results of surgery. Although 37.2% of the patients had surgical complications, 32 of the 43 individuals who underwent the surgical procedure were satisfied with the results. Conclusions: Treatment satisfaction of Peyronie's disease patients was higher for those submitted to surgical treatment compared to clinical treatment.

Peyronie's Disease, Erectile Dysfunction, Surgery, Penile Prosthesis

1. Ziegelmann MJ, Bajic P, Levine LA. Peyronie's disease: Contemporary evaluation and management. Int J Urol. 2020 Jun;27(6):504-516. https://doi.org/10.1111/iju.14230
2. Bella AJ, Perelman MA, Brant WO, Lue TF. Peyronie's disease (CME). J Sex Med. 2007 Nov;4(6):1527-38.
3. Miner MM, Seftel AD. Peyronie's disease: epidemiology, diagnosis, and management. Curr Med Res Opin. 2014 Jan;30(1):113-20. Epub 2013 Sep 30. doi: 10.1185/03007995.2013.842544
4. Davis SN, Ferrar S, Sadikaj G, Gerard M, Binik YM, Carrier S. Female Partners of Men With Peyronie's Disease Have Impaired Sexual Function, Satisfaction, and Mood, While Degree of Sexual Interference Is Associated With Worse Outcomes. J Sex Med. 2016 Jul;13(7):1095-103. https://doi.org/10.1016/j.jsxm.2016.04.074
5. Nelson CJ, Diblasio C, Kendirci M, Hellstrom W, Guhring P, Mulhall JP. The chronology of depression and distress in men with Peyronie's disease. J Sex Med. 2008 Aug;5(8):1985-90. https://doi.org/10.1111/j.1743-6109.2008.00895.x
6. Kern T, Ye N, Abdelsayed GA. Peyronie's Disease: What About the Female Sexual Partner? Sex Med Rev. 2021 Apr;9(2):230-235. https://doi.org/10.1016/j.sxmr.2020.11.002
7. Tsambarlis P, Levine LA. Nonsurgical management of Peyronie's disease. Nat Rev Urol. 2019 Mar;16(3):172-186. https://doi.org/10.1038/s41585-018-0117-7
8. Chung E, Ralph D, Kadioglu A, Garaffa G, Shamsodini A, Bivalacqua T, et al. Evidence-based management guidelines on Peyronie’s disease. J Sex Med. 2016 Jun;13(6):905-923. https://doi.org/10.1016/j.jsxm.2016.04.062
9. Hatzimouratidis K, Eardley I, Giuliano F, Hatzichristou D, Moncada I, Salonia A, et al; European Association of Urology. EAU guidelines on penile curvature. Eur Urol. 2012 Sep;62(3):543-52. https://doi.org/10.1016/j.eururo.2012.05.040
10. Nehra A, Alterowitz R, Culkin DJ, Faraday MM, Hakim LS, Heidelbaugh JJ, et al. American Urological Association Education and Research, Inc.,. Peyronie's Disease: AUA Guideline. J Urol. 2015 Sep;194(3):745-53. https://doi.org/10.1016/j.juro.2015.05.098
11. Porst H, Burri A; European Society for Sexual Medicine (ESSM) Educational Committee. Current Strategies in the Management of Peyronie's Disease (PD)-Results of a Survey of 401 Sexual Medicine Experts Across Europe. J Sex Med. 2019 Jun;16(6):901-908. https://doi.org/10.1016/j.jsxm.2019.03.404
12. Ibrahim A, Gazzard L, Alharbi M, Rompré-Brodeur A, Aube M, Carrier S. Evaluation of Oral Pentoxifylline, Colchicine, and Penile Traction for the Management of Peyronie's Disease. Sex Med. 2019 Dec;7(4):459-463. https://doi.org/10.1016/j.esxm.2019.07.003
13. Khera M, Bella A, Karpman E, Brant W, Christine B, Kansas B, et al. Penile Prosthesis Implantation in Patients With Peyronie's Disease: Results of the PROPPER Study Demonstrates a Decrease in Patient-Reported Depression. J Sex Med. 2018 May;15(5):786-788. https://doi.org/10.1016/j.jsxm.2018.02.024
14. Parikh NN, Heslop DL, Bajic P, Bole R, Farrell MR, Levine LA, et al. A Review of Treatment-Related Outcomes in Female Partners of Men With Peyronie's Disease-An Opportunity for Improved Assessment. Sex Med Rev. 2020 Oct;8(4):548-560. https://doi.org/10.1016/j.sxmr.2020.04.003
15. Loftus CJ, Rajanahally S, Holt SK, Raheem OA, Ostrowski KA, Walsh TJ. Treatment Trends and Cost Associated With Peyronie's Disease. Sex Med. 2020 Dec;8(4):673-678. https://doi.org/10.1016/j.esxm.2020.08.003
16. Ilg MM, Stafford SJ, Mateus M, Bustin SA, Carpenter MJ, Muneer A, et al. Phosphodiesterase Type 5 Inhibitors and Selective Estrogen Receptor Modulators Can Prevent But Not Reverse Myofibroblast Transformation in Peyronie's Disease. J Sex Med. 2020 Oct;17(10):1848-1864. https://doi.org/10.1016/j.jsxm.2020.06.022
17. Osmonov D, Ragheb A, Ward S, Blecher G, Falcone M, Soave A, et al. ESSM Position Statement on Surgical Treatment of Peyronie's Disease. Sex Med. 2022 Feb;10(1):100459. https://doi.org/10.1016/j.esxm.2021.100459
18. Chung E, Wang R, Ralph D, Levine L, Brock G. A Worldwide Survey on Peyronie’s Disease Surgical Practice Patterns Among Surgeons. J Sex Med 2018 Mar; 15 (4): 568-575. https://doi.org/10.1016/j.jsxm.2018.01.025
19. Kadioglu A, Sanli O, Akman T, Canguven O, Aydin M, Akbulut F, et al. Factors affecting the degree of penile deformity in Peyronie disease: an analysis of 1001 patients. J Androl. 2011 Sep-Oct;32(5):502-8. https://doi.org/10.2164/jandrol.110.011031
20. Abdelsayed, G. A., Setia, S. A., & Levine, L. A. (2019). The Surgical Treatment of Peyronie’s Disease in the Older Man: Patient Characteristics and Surgical Outcomes in Men 65 and Older. The Journal of Sexual Medicine. https://doi.org/10.1016/j.jsxm.2019.07.030