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Peyronie Disease

Peyronie Disease is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • Peyronie disease (PD) is a progressive connective tissue disorder affecting the tunica albuginea.
  • Results in aberrant fibrosis and inelastic scar (plaque) formation due to abnormal wound healing
  • Formation of plaque results in penile deformities: curvature, indentation, shortening, hourglass configuration, and/or painful erections.
  • PD is often accompanied with erectile dysfunction (ED).
  • Named after 18th-century French physician Francois de la Peyronie
  • The most common plaque location is on the dorsal aspect of the penis followed by lateral then ventral.
  • Curvature can range from mild to severe and may preclude sexual intercourse and cause psychological distress.
  • Synonyms: acquired penile curvature, penile induration

Epidemiology

Incidence
  • Between 3% and 9%
  • Reported in up to 9% of men >40 years of age (1)
  • Mean age of diagnosis: 53 years in white males

Prevalence
  • Estimated prevalence: 3–20% of men of all ages
  • Higher prevalence of up to 22.3% reported in patients with diabetes mellitus
  • Reported prevalence of concomitant ED: 37–58%

Etiology and Pathophysiology

  • Exact etiology unknown; generally thought to be secondary to trauma
  • Theory: Microtrauma in men with genetic predisposition leads to inflammation of the tunica albuginea, then collagen deposition, and eventually fibrosis in the form of a plaque.
  • Acute phase
    • 6–18 months of acute inflammation eventually leading to fibrosis and plaque formation
    • Painful erections that resolve spontaneously
    • Angulation in flux: 12% improve, 40% remain stable, 48% worsen (1,2)
  • Chronic phase
    • Stable plaque formation and angulation
    • Resolution of pain
  • Complete spontaneous resolution of PD is uncommon.
  • Most common presenting symptoms: penile pain, erection deformity, palpable plaque, ED

Risk Factors

  • Genetic predisposition/HLA-B7
  • Trauma

Commonly Associated Conditions

  • Dupuytren contracture
  • Ledderhose disease of plantar fascia
  • Tympanosclerosis of eardrum
  • ED

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Citation

Stephens, Mark B., et al., editors. "Peyronie Disease." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816904/all/Peyronie_Disease.
Peyronie Disease. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816904/all/Peyronie_Disease. Accessed April 21, 2019.
Peyronie Disease. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816904/all/Peyronie_Disease
Peyronie Disease [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 21]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816904/all/Peyronie_Disease.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Peyronie Disease ID - 816904 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816904/all/Peyronie_Disease PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -