—Dr. Trost’s Commentary and Key Take-home Points—
The current study provides some additional valuable information on conditions associated with Peyronie’s Disease. Specifically, the authors found that diabetes is clearly correlated with the condition, but other diagnoses, including hypertension, obesity, high cholesterol, smoking, or metabolic syndrome are not clearly associated. Although this information is not new, it does provide further support of a clear link between diabetes and Peyronie’s Disease. One novel, interesting finding from the study was that the rate of developing Peyronie’s was approximately 1% (0.5-3%) per year. This basically means that men in this group who were 60 years old were 20% (10-60%) more likely to have Peyronie’s Disease compared to men in their 40’s. To my knowledge, this is the first study to report such a statistic, and it provides valuable information for counseling. The study also provides further evidence that many conditions are not linked to Peyronie’s, including hypertension, smoking, or high cholesterol.
Although the specific cause for Peyronie’s Disease is not always identifiable in individual patients, there are several conditions which may contribute to its development. Dr. Saleh Binsaleh et al, performed a retrospective investigation of 1,662 patients to determine if metabolic syndrome (MS) increases the chance of a Peyronie’s diagnosis, which included a look into several other known factors including age, diabetes mellitus (DM), hypertension, obesity, dyslipidemia and smoking. Other than this hypothesis, this study revealed a few surprising data that are unique from other studies done on men with Peyronie’s.
Who Was Included in the Current Study
- The current study included 1,662 men who were being seen in a sexual medicine clinic for some sexual medicine complaint
How Was the Study Done
- Medical charts of the included men were reviewed
- Men with Peyronie’s were compared against men who did not have Peyronie’s to try to find important associations. In other words, the study investigators tried to determine if men who had Peyronie’s Disease had a higher rate of certain conditions (such as diabetes or metabolic syndrome) compared to those who didn’t have Peyronie’s
- The current study suggests a much higher rate of Peyronie’s than other studies, especially considering it was a much younger group overall with a mean age of 42.
- Only 7-10% of men with diabetes in the current study initially complained of Peyronie’s symptoms, but 20% were found to have Peyronie’s on examination.
- The risk of developing Peyronie’s Disease is approximately 0.5 to 3% per year, meaning that men who have had diabetes for a longer period of time were more likely to develop PD compared to those who had it for shorter periods of time. Although the study did not specifically indicate what the baseline year was for this increase, it likely was around 30-40 years, meaning that beginning around that time, the chance for developing Peyronie’s Disease goes up slightly each year.
- Hypertension has been variably associated with Peyronie’s and was not found to be linked in the current study
- The rate of Peyronie’s was 7% higher among men with diabetes compared to those who did not have diabetes
Data also suggest that diabetes exacerbates the severity of Peyronie’s, as men with DM have a greater risk of vascular issues, erectile dysfunction, and more severe Peyronie’s deformity. Many of the patients in this study had poor diabetes control, which accounts for the higher association with PD.
Despite the link with diabetes, the current study did not find an association with metabolic syndrome (MS). This was defined as 2 or more other diseases including hypertension, BMI >30, elevated triglycerides, low high-density lipoprotein, and high urinary albumin excretion rate. Although MS was not associated with PD, it was found to occur more often in men with uncontrolled DM. The authors suggest that based on their findings, screening for PD in younger men with diabetes may be warranted.
Reference for Article
Habous M, Malkawi I, Han E, Farag M, Muir G, Abdelwahab O, Nassar M, Mahmoud S, Santucci R, Binsaleh S. Peyronie’s disease is common in poorly controlled diabetics but is not associated with the Metabolic Syndrome. Urol Ann 2019;11:252-6