Understanding the course of Peyronie's disease. Issue 8 (22nd July 2013) - Garaffa, G.
Summary: Aims: To correct common misconceptions about Peyronie's disease (PD) that present obstacles to early recognition and treatment. Methods: The prevalence, natural disease course, psychosocial effects and treatment considerations for patients with PD were reviewed. Results: Studies over the past decade have shown that the prevalence of PD may be higher (up to 20%) than previously thought. PD can lead to emotional and relationship distress. Nearly 10% of men who present with PD are younger than 40. Both younger age and comorbid vascular disease have been associated with more severe and progressive PD. In the majority of patients, symptoms will either deteriorate or remain stable. PD is often associated with erectile dysfunction (ED). Effective, minimally invasive treatments used early in the disease course include unapproved and/or investigational intralesional injection therapy with verapamil, interferon (IFN) α‐2b, or collagenase clostridium histolyticum (CCH). Surgical intervention is considered in patients with ED and/or penile deformity that impairs sexual functioning; however, preoperative discussion of appropriate expectations is important. Discussion: The availability of effective minimally invasive and surgical therapies for PD suggests that active management should be considered over a 'wait‐and‐see' approach. Conclusion: Providing early intervention and improved education/awareness of PD as a chronic and progressive disorder may result in improved physical and psychosocial outcomes for PD patients. As general practitioners are often the first contact for men with PD, they are well positioned to recognise symptoms early and promptly refer patients for further evaluation and treatment.