Peyronie's Disease: More Common than You Realize
Peyronie'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 diagnostic criteria of PD are necessary to establish a diagnosis of Peyronie’s disease, although universal agreement cannot be found even on these matters: 1) detection of a nodule or mass of dense fibrous material known as a plaque or scar, primarily situated within layers of a tough but delicate membrane of tissue called the tunica albuginea, 2) slight to great pain that is felt during erection, although some men have no pain, and 3) bending or curvature of the penis . Most men with PD retain the ability to develop and maintain an erection. Some men may have difficulty achieving vaginal penetration because of curvature, pain for the man with PD or his partner pain during insertion.
Since only those people who personally deal with PD know anything about it, most lay people assume it is a rare health condition. However, that is not the case at all.
Recent review of Peyronie’s disease
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.
Several studies of Peyronie’s disease in the late 1980s reported the prevalence at 0.4% to 2.0% of the adult male US population.
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 Yet they are extremely shy and withdrawn concerning any aspect of PD because there is a high degree of shame and humiliation associated with the loss of penile size that happens with this problem.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.
Recent study of this question employed larger stduy groups of men with known and suspected PD, and cross-samples of data to verify the accuracy of data collected:
· Schwarzer and his colleagues created a PD questionnaire and sent it to 8,000 men of the region of Cologne, Germany. The response rate of men to this questionnaire was more than 55%, quite high. The results showed the occurence of Peyronie’s disease in this normal male population (mean age, 57.4 years) was a higher than expected 3.2%. Of those men of the 30-39 year age group, 1.5% demonstrated localized tissue hardening suggestive of PD; men 40-49 years of age this rate increased to 3.0% and in men 50-59 years of age the rate incrased to 4.0%. This occurence of tissue density or hardening increased along with advancing age to 6.5% in men older than 70 years. · 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; ( · The Department of Urology, Loyola University Medical Center, in Maywood, Illinois, did a study to determine the prevalence of Peyronie's disease in a group of men being screened for prostate cancer in the United States. In this Loyola study 534 men provided a medical history, received a physical examination performed by a urologist and completed a Sexual Health Inventory for Men (SHIM) questionnaire. A diagnosis of Peyronie's disease was formed if the presence of a palpable penile nodule could be made. Consequently, 48 men in this study were found to have a palpable nodular mass on physical examination, for Peyronie's diseae occurence 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
Many recent Peyronie's disease studies and reviews of medical literature indicate this problem is much more common in the male population than previously reported. Further, the greatest increase of incidence of PD is found to be in the older population (65+). The mean age of onset of PD is 53 years. While still not widely known in the general population, PD is not well-known within the medical community. This “rare” disease is more widespread than previous measures indicated.
