madman
Super Moderator
Peyronie disease (PD), first reported in 1743 as a disease,1 is now recognized in most cases to be the result of coital trauma to the penis. In 1997, Devine et al suggested that poor rigidity during penetrative sex causes delamination of the elastic covering (tunica albuginea) of the penile corpora cavernosa.2 The scar that forms as healing takes place is usually palpable, and this “plaque” and the erectile deformity are manifestations of PD.2 According to the National Institutes of Health consensus panel on impotence, erectile dysfunction (ED) is defined as the consistent inability to attain or maintain an erection of the penis sufficient to permit satisfactory sexual intercourse on more than 50% of attempts.3 Secondary ED that presents after a period of normal sexual function is preceded by declining penile rigidity with erection until a threshold is reached at which ED can be considered to exist.
Although PD and ED are linked, it is not clear which comes first owing to the lack of literature and studies regarding the timing of PD and ED onset.4,5 Men who have erections with decreased rigidity, even if still capable of penetrative sex and not yet diagnosed with ED, are at risk for penile fractures and PD.5
*REPORTED PREVALENCE OF PEYRONIE DISEASE
*MANAGEMENT AND PREVENTION
*SURGICAL MANAGEMENT
CLINICIAN EXPERIENCE
Evidence from the literature has been insufficient to constitute evidence-based diagnosis and treatment for PD.6 As a result, the American Urological Association uses a variety of sources for their recommendations, including expert opinion. Their 2015 PD guidelines are based primarily on clinical principles or expert opinions.6 According to Sackett, evidence-based medicine integrates individual clinical expertise with the best available evidence from systematic research.18
It has been through my years of experience with patients with PD, as well as the adoption of the paradigm noted above, that I have been able to provide effective relief for these patients. However, prospective studies to test this hypothesis are very difficult to execute.
Although PD and ED are linked, it is not clear which comes first owing to the lack of literature and studies regarding the timing of PD and ED onset.4,5 Men who have erections with decreased rigidity, even if still capable of penetrative sex and not yet diagnosed with ED, are at risk for penile fractures and PD.5
*REPORTED PREVALENCE OF PEYRONIE DISEASE
*MANAGEMENT AND PREVENTION
*SURGICAL MANAGEMENT
CLINICIAN EXPERIENCE
Evidence from the literature has been insufficient to constitute evidence-based diagnosis and treatment for PD.6 As a result, the American Urological Association uses a variety of sources for their recommendations, including expert opinion. Their 2015 PD guidelines are based primarily on clinical principles or expert opinions.6 According to Sackett, evidence-based medicine integrates individual clinical expertise with the best available evidence from systematic research.18
It has been through my years of experience with patients with PD, as well as the adoption of the paradigm noted above, that I have been able to provide effective relief for these patients. However, prospective studies to test this hypothesis are very difficult to execute.
