Peyronie's Disease

Peyronie's Disease: Quiet Male Health ProblemPeyronie's disease (PD) is said to be a rather rare disorder of the penis that has no agreement as to the cause or cure; even the cellular pathology is not completely understood. Three primary criteria of PD are needed to establish a diagnosis of Peyronie’s disease, even though universal concensus does not exist even on these: 1) presence of a palpable nodule of fibrous tissue (called a “scar” or plaque), primarily situated within layers of a tough but delicate membrane of tissue called the tunica albuginea, 2) variable pain reactions during an erection caused by tissue stretching , and 3) curvature or bending of the erect penis not present before PD developed. The majority of men who have PD still retain a variable ability to develop an erection. As a result, some of these men can have difficulty with vaginal penetration due to abnormal curvature, or pain for either partner during insertion.

Since so few people have ever heard of Peyronie’s disease, it is assumed it is a rare health problem. However, nothing could be further from the truth.

Recent review of Peyronie’s disease

According to a report published in 1995 by the National Institutes of Health, Peyronie's disease occurs in about 1% of men. It is said to be most common between the ages of 45 and 60, but it also occurs in young and elderly men. Prevalence may be higher because of reluctance to seek medical attention for the condition and failure to report.As some reports suggest, if Peyronie’s disease occurs in only one adult male of 200 (0.50%) in the US, that figure can be extrapolated to show that 1.4 million men have PD. In spite of this, Peyronie's disease is held out as a “rare disease” by the Office of Rare Diseases (ORD) of the National Institutes of Health (NIH), because other statistics they have developed suggests PD affects fewer than 200,000 men in the USA.

Peyronie’s disease was reported in several studies during the latter 1980s to be present in apporoximately 0.4% to 2.0% of US men. Now, based on additional investigation in the last several years, this number is increasing; perhaps this change is simply due to a greater openness about sexual subjects. Men have a tendency to both exaggerate and withhold information about matters related to sexuality. Yet they are extremely shy and withdrawn concerning any aspect of PD because there is a high degree of shame and humiliation associated with the loss of penile size that happens with this problem. For this reason information about Peyronie's diasese has proven to be most variable and unreliable. Previous data about frequency of PD used self-reporting surveys and unverified information; hence, the true rate of PD was an approximation or guess, at best.

This question has studied recently using much larger samples of men, over a wider age variance, and using more reliable and accurate survey methods to record the data collected:

Schwarzer, et al, used a PD questionnaire sent to 8,000 men around Cologne, Germany. The response rate of men to this questionnaire quite high - more than 55%. Results indicated the frequency of Peyronie’s disease in this normal male group (mean age, 57.4 years) to be an astounding 3.2%, or much greater than previously reported. Of the men in the 30-39 year age group, 1.5% had small localized nodules of dense tissue suggestive of PD; in the 40-49 year age group this rate increased to 3.0%; in the 50-59 year of age group it increased to 4.0%. In those men older than 70 years the presence of tissue density or hardening increased to 6.5%. All these age groups surpassed expectations. Of 142 men with a confirmed diagnosis of Peyronie’s disease, 58 (40.8%) admitted they also had concurrent erectile dysfunction, a known consequence of this disease. · Matkov and his researchers revealed that 30 (7%) of the 453 Peyronie’s disease patients being studied were younger than 40 years of age. Important characteristics of this more youthful PD group included: (1) recalled a specifica traumatic event during intercourse in which "ramming" or "jamming" occurred that was felt to be the start of the PD problem; (2) mild to extreme pain during an erection, presented as a major complaint; (3) men in a younger age category tend to have penile curvature about 10-20 degrees greater than men in an older age category. · Department of Urology, Loyola University Medical Center, Maywood, Illinois, conducted a study in which the prevalence of Peyronie's disease was determined in a group of men being screened for prostate cancer. In this study 534 men agve a complete medical history, and had a physical examination performed by a urologist, as well as completed a Sexual Health Inventory for Men (SHIM) questionnaire. Peyroie's disease would only be diagnosed only in the presence of a palpable penile nodular plaque. In this study, 48 of these men had such a palpable penile nodule detected on physical examination, creating 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. The conclusion of this study was that the prevalence of Peyronie's disease was greater than in most previously reported series.

Conclusion

Recent studies and reviews of the current medical literature indicates Peyronie’s disease is more common within the male population than previously recognized, and is greatly more common in the older (65+ years) population than any other age group. The average age of onset for PD is 53 years of age. It is clearly not well known among the general population, both male and female, it is not even well-known in the medical community. The reasons for this disparity are sundry, primarily more to due to social and psychosexual reasons than medical reasons. This is a “rare” disease that is obviously more widespread than previousky measured.