Erectile function profiles in men with Peyronie's disease.
OBJECTIVE
In this study we investigated the erectile function status of men presenting with Peyronie's disease.


METHODS
Demographics of patients regarding age, duration of PD, nature of deformity and comorbidities were compared between the patients with PD, with and without erectile dysfunction. Patients with erectile dysfunction underwent dynamic infusion cavernosometry/cavernosography. The hemodynamic profile of patients presenting with combined PD and ED were analyzed and compared between those with onset of ED before and after diagnosis of PD.


RESULTS
Of the 222 patients 78 had ED (35%) by self-report at presentation. The mean age of patients with PD and ED was 52 +/- 22 years old. Hypertension (71.5%), hyperlipidemia (60.4%) and smoking (49.2%) were the leading comorbidities in the entire group. Statistically significant differences were found between the groups with and without ED for hypertension (p = 0.02) and cigarette smoking (p = 0.009). Of 222 patients 45 (20%) had ED that predated PD onset (group 1) and 33 (15%) had ED that postdated the onset of PD (group 2). DICC showed normal hemodynamics in 14 of 78 patients (18%), arteriogenic insufficiency in 50 (64%) and corporoveno-occlusive dysfunction in 16 (20%). CVOD was evenly distributed between groups 1 and 2, whereas arteriogenic ED was significantly higher in group 1 (82%). Site specific leak was seen in 4 of 33 (12%), all group 2 patients.


CONCLUSIONS
Patients in whom ED postdates the onset of PD are more likely to have normal erectile hemodynamics. Site specific leak is an uncommon contributor to PD and is seen only in the patients with PD in whom ED postdated PD onset. The leading vascular etiology of ED in PD is arteriogenic in older patients and those with greater associated comorbidities.
Deveci
Serkan
S
Department of Urology, Weill Medical College of Cornell University, New York Presbyterian Hospital and Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Palese
Michael
M
Parker
Marilyn
M
Guhring
Patricia
P
Mulhall
John P
JP
D000328:Adult; D007172:Erectile Dysfunction / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D010411:Penile Induration / Q000150:complications* / Q000503:physiopathology*