(160) An Analysis of the Mis-Diagnosis of Peyronie’s Disease (PD) In Men Referred for the Assessment of Penile Deformity

Abstract

Abstract Introduction PD is diagnosed in the presence of penile deformity combined with a tunical plaque. Clinical experience shows us that some men who believe they have PD actually have congenital penile curvature (CPC), whilst others, especially those with a history of penile trauma, have anxiety about having PD but, in fact, do not. Objective This analysis aimed to define the mis-diagnosis rate of men referred for PD evaluation. Methods Study population consisted of men who (i) presented to a sexual medicine clinic for the evaluation of penile deformity (ii) and/or the presence of a tunical nodule (iii) underwent comprehensive penile examination by a sexual medicine physician with extensive experience in PD and (iv) underwent penile deformity assessment at the time of penile duplex Doppler ultrasound (PDDU). Demographic and comorbidity data were recorded. Multivariable analysis (MVA) was conducted to define predictors of the absence of PD. Results 1942 patients met the inclusion criteria. 79% were MD referred (MDR), the remainder were self-referred (SR). Mean age of the entire cohort was 58±28 years (MDR 64±22y, SR 41±11y, p<0.01). Comorbidities: hypertension 24%, diabetes 11%, dyslipidemia 27%, chronic pelvic pain syndrome (CPPS) 6%, history of radical pelvic surgery (RPS) 24%, history of penile trauma 8%. Overall 14% of patients had no PD plaque identified on examination (MDR 12%, SR 21%). For MDR without PD, majority had CPC (9%), 3% had no deformity, while for SR only 6% had CPC, the remaining 15% had no deformity at PDDU. Results of MVA is presented in the Table. Conclusions Men referred to a tertiary referral center for the evaluation of PD commonly have no PD. Predictors of no PD include: diagnosis of CPPS, history of penile trauma, young age and absence of RPS. Disclosure No