Peyronies Disease: Rare or Common?

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Peyronie's Disease: Rare or Common?

Peyronie's disease (PD) is thought to be a rare connective tissue disorder of the penis that has no known cause or cure; even the celluar mechanism of how PD starts is not completely understood. Three primary diagnostic criteria of PD are necessary to establish a diagnosis of Peyronie’s disease, even though there is no universal agreement even on the following: 1) existence of a nodule or band of variable size made of fibrous scar tissue ) called a scar or plaque, chielfy found in a thin but tough tissue membrane known as the tunica albuginea, 2) variable pain that occurs during erection, and 3) penile curvature or bend that was not present before the onset of PD. Most men with PD retain the ability to develop and maintain an erection. Because of the physical and functional changes of PD, these men suffer difficulty with vaginal penetration as a result of abnormal curvature, impotence, or pain for either partner during insertion.

Since only those people who personally deal with PD know anything abot it, most lay people assume it is a rare health condition. However, that is not the case at all.

Recent review of the frequency 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.

Since there is a tendency for men to both exaggerate in some cases about matters related to sexuality, yet at the same time to be shy and withdrawn concerning certain matters of sexuality, data concerning the occurrence of PD has proven to be most variable and unreliable. Previous information about frequency of PD relied upon surveys and interviews that used self-reporting and unverified information; hence, the actual rate of occurrence was merely 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) moderate to great pain during erection as a major presenting 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 average age of men with Peyronie's disease was 68.2 years compared to an average age of 61.8 years in men without Peyronie's disease. This study concluded that the prevalence of Peyronie's disease was hihger in the general population, and especially in the older population, than in previously reported series.

Conclusion

These and many other recent studies and reviews of medical literature indicate Peyronie’s disease is far more common among the general male population than previously thought, and increasingly common in the older population. The mean onset of PD is about 53 years of age. While it is still not widely known among the general population, it is actually not even well-known within the medical community. This “rare" disease is obviously more widespread and less rare than previous measures indicated.



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