–Trost Commentary and Key Take-home Points–
This current study highlights how common issues such as indentations, hourglass deformities, or other similar findings are among men with Peyronie’s Disease. These types of deformities can be particularly bothersome for individuals as they may cause buckling, instability, or anxiety for men during penetrative intercourse (i.e. fear of instability / caution). They also can result in greater impairments in erectile function beyond the area of indentation. Unfortunately, at the present time, there are not many conservative therapies which address those types of deformities well. From a surgical standpoint, it is possible to place a graft in the area of indentation / hourglass, and this can provide some additional support. However, surgery, in general, is not desired by the majority of men with PD.
Peyronie’s disease is a fibrotic disease causing penile deformity and pain. Curvature of the penis is the most recognized indicator of Peyronie’s disease, but other deformities, like decrease in penile length or girth, indentations and hourglass deformities, can also occur. All of these symptoms can interfere with sexual intercourse and cause psychological distress. As penile shortening other deformities cause more distress than curvature alone, the purpose of this article is to assess the clinical importance and prevalence of these non-curvature deformities.
The 128 patients selected for this study included men with Peyronie’s disease, curvature >10 degrees, good erectile ability with injection, and penile-volume loss deformities such as hourglass, unilateral indentations or distal tapering. 65% of these men had a specific volume-loss deformity.
Results of this study showed the men with volume-loss deformities had higher rates of axial instability, psychological distress and decreased sexual activity. These negative effects had the highest rates among men with indentation deformities compared to hourglass or distal tapering. These findings are similar to the results of previous studies, showing the need for more robust studies and treatments for these clinically significant volume-loss deformities.