(490) The Ins and Outs of Peyronie’s Disease: An Evaluation of Endoscopic Associations

Abstract

Abstract Introduction Peyronie’s disease (PD) is a fibroproliferative disorder of the tunica albuginea of the penis. Though the etiologies and potential mechanisms for PD remain understudied, known PD risk factors include family history, Dupuytren disease, diabetes mellitus, smoking, hypertension, and penile trauma. Endoscopic procedures have also been reported as a cause of PD. Although often referenced, current literature contains little evidence describing the potential association of endoscopic procedures with the development of PD. Objective To evaluate the association of endoscopic procedures and patient demographics in men with the development of Peyronie’s disease Methods Institutional review board approval was obtained, and a retrospective review was performed at a tertiary referral center of all patients with history of urologic endoscopy who were subsequently diagnosed with PD from January 2010 to January 2022. Electronic medical records were searched for ICD-9 and ICD-10 codes to identify unique records with a diagnosis of PD. Records were also identified by CPT codes for transurethral and percutaneous urologic endoscopic procedures. Endoscopic procedures were evaluated for the type of instrumentation and divided into 4 broad categories: diagnostic cystoscopy, urethral stricture manipulation, transurethral resection, and endoscopic treatment for urinary lithiasis. Records were evaluated for time to PD diagnosis following their procedure, presence of a post-operative urethral catheter, and demographic data. Results A total of 19,383 unique patients with endoscopy procedures and 629 unique patients with PD diagnosis were identified. 121 patients had a diagnosis of PD and history of endoscopy, of whom 50 patients (7.9%) were confirmed to have had endoscopy prior to PD diagnosis. The median age of PD diagnosis was 62. There was no increased association between PD and endoscopy in men with a diagnosis of diabetes (p = 0.5261), hypertension (p = 0.2256), or a history of smoking (p = 0.9398). The majority of PD diagnoses (54%, 27/50) were associated with cystoscopy performed supine (48.1%, p=0.0011), in a clinic (40.7%, p = 0.0001), and with flexible instrumentation (55.6%, p<0.0001). Postoperative urethral catheter use was not associated with PD (p = < 0001. There was no association between the time to presentation of PD and the procedure performed (p=0.73). Conclusions Men with a diagnosis of PD and a history of prior urologic endoscopy are more likely to have undergone a simple, flexible cystoscopy in the clinic setting. There does not appear to be an association between the time to presentation of PD and the endoscopic procedure performed. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Endo Pharmaceuticals