Clinical and epidemiological characteristics of young patients with Peyronie's disease: a retrospective study

Abstract

Gianni Paulis,1,7 Giorgio Cavallini,2 Davide Barletta,3 Paolo Turchi,4 Antonio Vitarelli,5 Andrea Fabiani6 1Regina Apostolorum Hospital, Andrology Center, Rome, Italy; 2Andrological Section, Gynepro Medical Team, Bologna, Italy; 3Department of Urology, Andrology Center, San Matteo Hospital, Pavia, Italy; 4Azienda ASL 4 Prato – Andrology Service, Prato, Italy; 5Department of Urology, University of Bari, Bari, Italy; 6Department of Surgery, Section of Urology and Andrology, ASUR Marche 9, Macerata, Italy; 7Castelfidardo Medical Team, Peyronie's Disease Care Center, Rome, Italy Abstract: The average age of men affected by Peyronie's disease (PD) is approximately 50–55 years, but cases have been reported even in adolescence. Several studies have already investigated the presence of PD in young men, and these studies reported a PD prevalence that varies between 1.5% and 10.8%. Having noticed a greater number of young patients in our centers in recent years, we decided to carry out a retrospective study to evaluate the prevalence of PD in patients aged <40 years, as well as to investigate any possible difference in evolution based on the age of PD patients. We selected a sample of patients (n=271) with a similar time of onset of disease. We then stratified all 271 patients into two groups: group A (age <40 years [n=46]) and group B (age ≥40 years [n=225]). All 271 patients were evaluated for the following variables: penile plaque volume, degree of penile curvature, penile pain, and erectile function. Plaque volume was measured in cm3 by dynamic penile color Doppler sonography after administration of intracavernosal alprostadil 10 mcg. The number of younger patients was 46, accounting for 16.9% of the whole sample. Our study showed more frequent appearance and greater progression of penile curvature in younger patients. The average angle of penile curvature and average score of penile pain intensity in the younger men were significantly higher than in patients aged ≥40 years (P=0.025 and P=0.0001, respectively). In the younger patients, not only was the pain more intense (visual analog scale [VAS] of 5.2 versus 3.8), but it was also more frequently present than in patients aged ≥40 years (78.2% versus 62.2%) (P=0.042). We may conclude that since PD in young patients has a more acute onset and a greater possibility of progression, it should be treated conservatively as soon as it is diagnosed. Keywords: Peyronie, young men, prevalence, penile curvature