ORIGINAL RESEARCH—PEYRONIE’S DISEASE: Peyronie’s Disease Following Radical Prostatectomy: Incidence and Predictors

The Journal of Sexual Medicine - Tập 7 - Trang 1254-1261 - 2010
Raanan Tal1, Matthias Heck1, Patrick Teloken1, Timothy Siegrist1, Christian J. Nelson2, John P. Mulhall1
1Male Sexual & Reproductive Medicine Program, Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA;
2Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA

Tóm tắt

ABSTRACT Introduction Both prostate cancer and Peyronie’s disease (PD) are prevalent in men after their fifth decade of life. The evidence to support or refute a link between radical prostatectomy (RP) and PD is limited. Aims To define the incidence of PD in men who had RP and determine possible predictors of PD development after RP. Methods A review of a prospectively built sexual medicine database, years 2002–2008, looking at subjects who had RP as a monotherapy for localized prostate cancer. We identified and characterized subjects who developed PD within 3 years after RP and compared them with subjects who did not. Main Outcome Measures The incidence of PD among men who attended a sexual medicine clinic after they had RP, predictors of PD development after RP. Results The study population included 1,011 subjects, and PD incidence in this population was 15.9%. Mean time to develop PD after RP was 13.9 ± 0.7 months. Mean curvature magnitude was 31+17 degrees. On univariate analysis, younger age (mean age of 59+7 in men with PD vs. 60+7 years in men without PD, P = 0.006) and white race (vs non-white, 18% vs. 7%, P <0.001) were predictive of PD development after RP, but post-op erectile function was not a predictor of PD development. On multivariate analysis, younger age (odds ratio (OR)=1.3, for 5-year decrease in age) and white race (OR=4.1, vs. non-white) remained independent significant predictors. Conclusions Men presenting with sexual dysfunction after RP have higher PD incidence then the general population. Therefore, they should be routinely evaluated for PD. Younger men and men of white race are at increased risk for PD. Prospective controlled studies are needed to elucidate the incidence of PD following RP and to conclude if RP has a causative role in the pathogenesis of PD.

Tài liệu tham khảo

Jemal, 2009, Cancer statistics, 2009, CA Cancer J Clin, 59, 225, 10.3322/caac.20006 Schwarzer, 2001, The prevalence of Peyronie’s disease: Results of a large survey, BJU Int, 88, 727, 10.1046/j.1464-4096.2001.02436.x La Pera, 2001, Peyronie’s disease: Prevalence and association with cigarette smoking. A multicenter population-based study in men aged 50–69 years, Eur Urol, 40, 525, 10.1159/000049830 Mulhall, 2004, Subjective and objective analysis of the prevalence of Peyronie’s disease in a population of men presenting for prostate cancer screening, J Urol, 171, 2350, 10.1097/01.ju.0000127744.18878.f1 Iacono, 2005, Histological alterations in cavernous tissue after radical prostatectomy, J Urol, 173, 1673, 10.1097/01.ju.0000154356.76027.4f Bjekic, 2006, Risk factors for Peyronie’s disease: A case-control study, BJU Int, 97, 570, 10.1111/j.1464-410X.2006.05969.x Carrieri, 1998, A case-control study on risk factors for Peyronie’s disease, J Clin Epidemiol, 51, 511, 10.1016/S0895-4356(98)00015-8 Ciancio, 2000, Penile fibrotic changes after radical retropubic prostatectomy, BJU Int, 85, 101, 10.1046/j.1464-410x.2000.00364.x Ohebshalom, 2007, Measurement of penile curvature in Peyronie’s disease patients: Comparison of three methods, J Sex Med, 4, 199, 10.1111/j.1743-6109.2006.00404.x Deveci, 2007, Defining the clinical characteristics of Peyronie’s disease in young men, J Sex Med, 4, 485, 10.1111/j.1743-6109.2006.00344.x El-Sakka, 2006, Prevalence of Peyronie’s disease among patients with erectile dysfunction, Eur Urol, 49, 564, 10.1016/j.eururo.2005.10.026 Babyak, 2004, What you see may not be what you get: A brief, nontechnical introduction to overfitting in regression-type models, Psychosom Med, 66, 411 Rhoden, 2001, Prevalence of Peyronie’s disease in men over 50-y-old from Southern Brazil, Int J Impot Res, 13, 291, 10.1038/sj.ijir.3900727 Smith, 1969, Subclinical Peyronie’s disease, Am J Clin Pathol, 52, 385 Tal, 2008, Intracavernosal injections and fibrosis: Myth or reality?, BJU Int, 102, 525, 10.1111/j.1464-410X.2008.07738.x Agrawal, 2008, Systemic vascular endothelial dysfunction in Peyronie’s disease, J Sex Med, 5, 2688, 10.1111/j.1743-6109.2008.00947.x