Peyronie's Disease: A Clinical Update

Some of us are at increased risk of Peyronie's Disease. This clinical
update may be useful reading...

Just


"Initial reports estimated the prevalence of PD at approximately 1%.
More recent population studies indicate that this may be a significant
underestimate of the true prevalence. One of the largest population
studies examined 8000 German men and found an overall prevalence of
3.2% as defined by a palpable penile plaque. The incidence also
increased with age, which contradicts previous prevalence reports
stating that the highest incidence was found among men in their
fifties. Another recent study examining objective evidence of PD in
men undergoing prostate cancer screening found a prevalence of 8.9%.
One theory for the increasing incidence of PD, especially in older
men, could be the increasing use of pharmacotherapy for ED.
Phosphodiesterase (PDE) type 5 inhibitors are not believed to cause
PD; however, intracavernosal injection agents may increase the risk
for plaque formation. Presumably, this increased risk stems from local
trauma secondary to the injection technique. Recent evidence also
suggests that the development of PD is increased after radical
prostatectomy".

"Contrary to what was once thought, evidence suggests that there is
minimal spontaneous resolution of PD. In fact, in a study following
men up to 8 years, only 13% of participants felt that there had been
any spontaneous improvement. Forty-seven percent of patients in this
study thought that the disease had stabilized and 40% noted worsening
of symptoms".

"PD is more prevalent than previously realized and can have
significant effects on a man's quality of life. Treatment modalities
to correct the curvature and maintain or improve erectile function
cover a wide range of modalities, from medical to surgical options.
Patients need to be counseled thoroughly regarding the natural history
of the disease and to have realistic expectations regarding treatment
outcomes in terms of change in length, sensation, and erectile
function. With a motivated and informed patient, treatment options are
more successful at restoring functional capacity and patient
satisfaction".

http://www.medscape.com/viewprogram/15718_pnt

On Aug 7, 8:53 am, Just <h...@anon.com> wrote:
> Some of us are at increased risk of Peyronie's Disease. This clinical
> update may be useful reading...
>
> Just
>
> "Initial reports estimated the prevalence of PD at approximately 1%.
> More recent population studies indicate that this may be a significant
> underestimate of the true prevalence. One of the largest population
> studies examined 8000 German men and found an overall prevalence of
> 3.2% as defined by a palpable penile plaque. The incidence also
> increased with age, which contradicts previous prevalence reports
> stating that the highest incidence was found among men in their
> fifties. Another recent study examining objective evidence of PD in
> men undergoing prostate cancer screening found a prevalence of 8.9%.
> One theory for the increasing incidence of PD, especially in older
> men, could be the increasing use of pharmacotherapy for ED.
> Phosphodiesterase (PDE) type 5 inhibitors are not believed to cause
> PD; however, intracavernosal injection agents may increase the risk
> for plaque formation. Presumably, this increased risk stems from local
> trauma secondary to the injection technique. Recent evidence also
> suggests that the development of PD is increased after radical
> prostatectomy".
>
> "Contrary to what was once thought, evidence suggests that there is
> minimal spontaneous resolution of PD. In fact, in a study following
> men up to 8 years, only 13% of participants felt that there had been
> any spontaneous improvement. Forty-seven percent of patients in this
> study thought that the disease had stabilized and 40% noted worsening
> of symptoms".
>
> "PD is more prevalent than previously realized and can have
> significant effects on a man's quality of life. Treatment modalities
> to correct the curvature and maintain or improve erectile function
> cover a wide range of modalities, from medical to surgical options.
> Patients need to be counseled thoroughly regarding the natural history
> of the disease and to have realistic expectations regarding treatment
> outcomes in terms of change in length, sensation, and erectile
> function. With a motivated and informed patient, treatment options are
> more successful at restoring functional capacity and patient
> satisfaction".
>
> http://www.medscape.com/viewprogram/15718_pnt

I wonder if PD effect on those with PCa is affecting those with RP.
Think about this: with RP, the urethra is pulled up to bladder neck
so they can be joined after the prostate is removed. Over time, the
penis starts to bend due the shortened urethra. If you pull a string
inside a tube where one end is fixed, that tube will bend.

cmdrdata wrote:
> On Aug 7, 8:53 am, Just <h...@anon.com> wrote:
>> ... One of the largest population
>> studies examined 8000 German men and found an overall prevalence of
>> 3.2% as defined by a palpable penile plaque.
> ...
> I wonder if PD effect on those with PCa is affecting those with RP.
> Think about this: with RP, the urethra is pulled up to bladder neck
> so they can be joined after the prostate is removed. Over time, the
> penis starts to bend due the shortened urethra. If you pull a string
> inside a tube where one end is fixed, that tube will bend.

Speaking mostly from ignorance here, I'm inclined to think that
reduction of the size of the urethra wouldn't, by itself, cause it.

Note the presence of "palpable penile plaque". As I understand it,
PD is the effect of "fibrosis" of tissue in the penis. "Fibrosis"
is the replacement of flexible tissue with much less flexible fiber
like tissue. It can happen as a result of injury, and is apparently
a common effect of radiation on tissue.

I never had any PD until after the end of radiation treatment.
I didn't notice it because, with Lupron, I had very few erections
for about 6 months. I most suspect the radiation. I was told
that I was being treated for one centimeter around the prostate
as well as the prostate itself, and I wonder if some of those
x-rays hit the base of the penis. However I also wonder if just
lack of erections could be a cause - which is something that can
happen for significant periods to men treated with any of the
usual techniques.

Whatever the cause, I haven't found it to interfere with sex
or be a problem. But perhaps my case isn't very severe.

Alan

On Aug 7, 10:48 pm, Alan Meyer <amey...@yahoo.com> wrote:
> cmdrdata wrote:
> > On Aug 7, 8:53 am, Just <h...@anon.com> wrote:
> >> ... One of the largest population
> >> studies examined 8000 German men and found an overall prevalence of
> >> 3.2% as defined by a palpable penile plaque.
> > ...
> > I wonder if PD effect on those with PCa is affecting those with RP.
> > Think about this: with RP, the urethra is pulled up to bladder neck
> > so they can be joined after the prostate is removed. Over time, the
> > penis starts to bend due the shortened urethra. If you pull a string
> > inside a tube where one end is fixed, that tube will bend.
>
> Speaking mostly from ignorance here, I'm inclined to think that
> reduction of the size of the urethra wouldn't, by itself, cause it.
>
> Note the presence of "palpable penile plaque". As I understand it,
> PD is the effect of "fibrosis" of tissue in the penis. "Fibrosis"
> is the replacement of flexible tissue with much less flexible fiber
> like tissue. It can happen as a result of injury, and is apparently
> a common effect of radiation on tissue.
>
> I never had any PD until after the end of radiation treatment.
> I didn't notice it because, with Lupron, I had very few erections
> for about 6 months. I most suspect the radiation. I was told
> that I was being treated for one centimeter around the prostate
> as well as the prostate itself, and I wonder if some of those
> x-rays hit the base of the penis. However I also wonder if just
> lack of erections could be a cause - which is something that can
> happen for significant periods to men treated with any of the
> usual techniques.
>
> Whatever the cause, I haven't found it to interfere with sex
> or be a problem. But perhaps my case isn't very severe.
>
> Alan

Alan, I had my RT almost 1.5 year ago, and everything is fine
in that department. No problem with erection, PD, or urinary.
Do you think that stray radiation caused the palpable plaque?
Modern day RT is touted as being so precise (mm accuracy)
so I don't understand your reasoning. I also mentioned
shortening of the length of the urethra, not the size.
most RP patient reported overall shortening of the penis,

cmdrdata wrote:
> ...
> Do you think that stray radiation caused the palpable plaque?
> Modern day RT is touted as being so precise (mm accuracy)
> so I don't understand your reasoning. I also mentioned
> shortening of the length of the urethra, not the size.
> most RP patient reported overall shortening of the penis,

I really have no way to know whether radiation affected
me in that way or not. There's no way to find out. It
might be the cause, or it might be totally unrelated. I
only speculated on radiation as a cause because, first,
I never noticed any PD until about 10 or 12 months after
the radiation, and second, because I read that radiation
can induce fibrosis in tissue.

My rad onc said he didn't think it was likely. But who
knows?

Life is too short to worry much about things like this.

Alan