161 Beyond Curvature: Prevalence and Characteristics of Volume Loss Deformities in Men with Peyronie's Disease

Abstract

We sought to describe the prevalence and functional impact of non-curvature, penile volume-loss deformities in our cohort of men with Peyronie’s disease (PD). We retrospectively examined medical records of patients with PD who consecutively underwent penile duplex doppler ultrasound (PDDU) with physical examination of the erect penis after intracavernosal injection by a specialized urologist from December 2012- July 2015. Curvature was measured with goniometer. Volume loss deformities were characterized as hourglass deformities, unilateral indentations, and distal tapering based on physical examination. Axial instability was determined subjectively as present when application of axial force resulted in penile buckling. Each patient completed the Male Sexual Health Questionnaire (MSHQ) and was asked if they experienced anxiety about sexual performance. Clinical data of patients with and without volume-loss deformities were compared using chi-squared tests and two-sided t-tests. 54% of the cohort (62/114) had volume-loss deformities. Hourglass deformities, distal tapering and unilateral indentations were present in 27 (24%), 17 (15%), and 18 (16%) patients, respectively. Curvature was present in 109 patients (96%). The patients with volume-loss deformities had significantly higher rates of axial instability (40% vs. 22%, p=0.04) and anxiety about sexual function (18% vs. 6%, p=0.05) compared to patients without volume-loss deformities. We did not observe differences in PDDU parameters or any of the 5 MSHQ sexual function domain scores between patients with and without volume-loss deformities, although men with volume-loss deformities had more instances of perceived delayed ejaculation (4.1 vs. 3.5, p=0.04).