The Clinical Characteristics of Peyronie’s Patients with Notching Deformity

Abstract

Peyronie's patients with notching deformity represent a small percentage of disease population, and the features of these patients have not been well established yet. To analyze the characteristics of Peyronie's patients with notching deformity. Peyronie's patients with notching deformity were compared with those with other type of penile deformities with regard to clinical features. During a 13-year period, a total of 703 patients with Peyronie's disease were evaluated at our institution. The patients were divided into two groups: group I consists of Peyronie's patients with notching deformity (N = 89) and group II patients with any other kind of penile curvature (N = 614). The clinical characteristics, presence of co-morbidities including diabetes mellitus, hypercholesterolemia, hypertriglyceridemia, hypertension, and ischemic heart disease, erectile status, and penile deformities were compared between the two groups. Pure notching deformity was detected in 12.6% (N = 89) of the patients. The mean age of men was 53.1 +/- 10.2 and 52.7 +/- 10.7 years in groups I and II, respectively, (P = 0.8). The leading presenting symptom was erectile dysfunction (68.5%), followed by penile deformity (51.6%), and pain on erection (17.9%) in group I, while it was penile curvature (77.1%), erectile dysfunction (54.6%), and pain on erection (14.4%) in group II. In group I, 27 patients (30.3%) were diagnosed during a standard evaluation for erectile dysfunction. Hypertension was significantly higher in group I (25.8%) than in group II (15.4%) (P = 0.022); whereas hypercholesterolemia was more common in group II (P = 0.008). There was no significant correlation between the presence or the number of co-morbid conditions and the presence of the notching deformity. Combined injection and stimulation test revealed a diminished erectile capacity in 46.1% of the patients in group I, while it was 31.7% in group II (P = 0.008). In group I, 62.9% had unilateral notching deformity, 34.8% had hourglass deformity, and 2.2% had combined hourglass and notching deformity. Overall, the notching deformity was localized in the distal penile shaft in 50.5%, proximal shaft in 40.4%, and mid-shaft in 8.9% of the patients in group I. In this large-scale series, pure notching deformity was detected in about one-tenth of patients with Peyronie's disease. Patients presented at the first half of the sixth decade of life and more than half of the patients were in the acute phase of the disease. The most common presenting symptom was erectile dysfunction. The notching deformity was more frequently localized at the base and tip of the penis.