title: Peyronie's disease: urologist's knowledge base and practice patterns.
abstract: Peyronie's disease (PD) is a poorly understood clinical entity. We performed an in-depth analysis of the knowledge base and current practice patterns of urologists in the United States. A 46-question instrument was created by two experienced PD practitioners and emailed to current American Urology Association members nationally. Questions were either multiple-choice or used a visual analogue scale. Responses regarding treatment options were answered by ranking a list of utilized therapies by preference. Data were aggregated and mean values for each category compiled. Responses were received from 639 urologists (67% in private practice). Almost all (98%) reported seeing PD patients with regularity. Twenty-six percent believed PD prevalence is ≤1%, a small fraction (5%) reporting prevalence as ≥10%. Only 3% referred patients to a subspecialist in PD. Twenty-six percent believed PD is a condition that does not warrant any treatment. The preferred initial management was with oral agents (81%). Of those who used intralesional injections as first line, verapamil was most commonly selected (67%). Seventy-nine percent perform surgery for PD with 86% reporting the optimal timing at ≥12 months after onset of symptoms. Seventy percent perform penile plication, most commonly the Nesbit technique (54%), 61% perform implant surgery and 37% reported performing plaque incision/excision and grafting. Although PD is now a more recognized condition, there are still large variances in knowledge and management strategies. Prospective clinical studies are needed to elucidate standardized management guidelines and a more cohesive strategy to manage this common disease.
authors.affiliation: Urology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: J
authors.initials: J
authors.lastname: Sullivan
authors.forename: D
authors.initials: D
authors.lastname: Moskovic
authors.forename: C
authors.initials: C
authors.lastname: Nelson
authors.forename: L
authors.initials: L
authors.lastname: Levine
authors.forename: J
authors.initials: J
authors.lastname: Mulhall
mesh_terms: D006801:Humans; D051188:Knowledge Bases; D008297:Male; D010411:Penile Induration / Q000628:therapy*; D014572:Urology; D000078329:Workforce
keywords: Peyronie's disease; medical management; practice patterns; surgical management; survey