Deformity stabilization and improvement in men with untreated Peyronie's disease

Abstract

Objective To define predictors of the deformity stabilisation and improvement in men with untreated Peyronie's disease (PD). Patients and Methods The study population consisted of patients with PD‐associated uniplanar curvature, who opted for no treatment and were followed for at least 12 months. All patients had deformity assessment (DA) performed on initial presentation and at follow‐up. Stabilisation of PD was defined as no change between DAs (±10°), while improvement and progression were defined as ≥10° change. Patients were subdivided into different groups based on time to presentation: ≤6 months (A), 7–12 months (B), and 13–18 months (C). Multivariable analysis was used to define predictors of stabilisation and improvement. Results In all, 176 men met the inclusion criteria. The mean age was 54 years, with a mean (sd) PD duration of 9 (12) months and mean curvature of 42 (27)°. In all, 67% of the entire population had no change in deformity over time, 12% improved with a mean (sd) change of 27 (14)°, and 21% worsened with a mean (sd) change of 22 (11)°. On multivariate analysis, predictors of stabilisation included: time to presentation of >6 months (odds ratio [OR] 2.4, P < 0.01), per decade increase in age (OR 1.5, P < 0.05), and age (r = 0.32, P < 0.05). Predictors of improvement included: time to presentation of ≤6 months (OR 4.1, P < 0.001), and per decade decrease in age (OR 2.1, P < 0.01). Conclusions In men with uniplanar curvature, PD stabilisation and improvement rates change with time‐to‐presentation and patient age. These data may aid in counselling patients with PD.

Evaluation of the benefit of using a combination of autologous platelet rich-plasma and hyaluronic acid for the treatment of Peyronie’s disease

“…Nevertheless, available previous placebo -controlled studies [7] show a maximum angle reduction of 21% with Impress I and of 15.2% for the placebo group. Furthermore, the comparison of our results with those of untreated patients, as in Berookhim's trial [17] conducted on 176 patients to study the natural history of PD in the absence of medical or surgical therapy, further supports a beneficial effect of the combination of PRP and HA, as only 12% of untreated patients had an improvement of their deformation vs 62% in the present study.…”

Peyronie’s Disease: A Review of Etiology, Diagnosis, and Management

“…61 Berookhim et al reported a 12% improvement rate in untreated men with uniplanar PD, with time to presentation of ≤ 6 months and younger age as predictors of improvement. 62 Perhaps more significantly, 67% of men in this cohort remained stable, and 21% worsened during the follow-up period of at least 12 months. Another study observed a 30% progression rate in 307 men with PD over 8 months, with resolution occurring in only 0.65% of cases.…”

Intralesional Injection of Hyaluronic Acid in Patients Affected With Peyronie's Disease: Preliminary Results From a Prospective, Multicenter, Pilot Study

“…In 1743, Francois Gigot de la Peyronie's wrote a landmark article on PD, and his name was associated with the disease. Despite this long history, there are no medical or surgical therapies 10 and there is a paucity of knowledge on the natural history of PD, although deformity stabilization and improvements in specific subsets of men with untreated PD have recently been reported 11 …”