History and Diagnosis
The earliest known mention of Peyronie's Disease was possibly in 3000 BC. This is evidenced by a Minoan sculpture that was found in the sanctuary of a deity with healing powers. As the sculpture was the only one demonstrating an erect penis with a distinct ventral curvature and no other visible maladies, this was felt to be of the earliest evidence of the condition.(1)
Later mentions are found in 1561, which is believed to be the earliest recorded description of the condition.(2)
References: 1 - Laios K, et al: 2013 J Sex Med; 2 - Jalkut M, et al: 2003 Rev Urol.
Peyronie's Disease received its current name from Francois Gigot de La Peyronie after he described a chronic, fibrosing condition of the penis in 1743. At the time, he was the personal physician to King Louis XV although it is unclear if King Louis XV exhibited signs of Peyronie's.
Although the condition is commonly referred to as Peyronie's Disease, it is likely more accurate to refer to the condition as Lapeyronie's Disease.
There is some debate as to whether or not Peyronie's should be referred to as a disease. Some feel that given its high prevalence and non-malignant potential, it is a normal 'variant' of the penis and not a true disease.
However, if you use a commonly accepted definition for disease as, "a disorder of structure or function in a human," this would likely classify Peyronie's as a diseased state of the penis.
Peyronie's Disease is a chronic, fibrosing condition of the penis that can result in deformity and/or loss of function.(1)
Peyronie's Disease is a 'clinical diagnosis,' which means that there are not any laboratory, imaging, or other similar studies which can definitively diagnose Peyronie's Disease. Similarly, there is not one specific finding which always leads to a diagnosis of Peyronie's Disease.
The condition can occur with any combination of symptoms including curvature, palpable nodule (bump), penile pain, erectile dysfunction, penile deformity or shortening, among others.(2-5) However, each of these symptoms can also occur in isolation and not be due to Peyronie's Disease.
References: (1) Commonly accepted definition in published literature; (2) Kadioglu A, et al: 2002 J Urol; (3) Rhoden EL, et al: 2010 J Sex Med; (4) Kadioglu A, et al: 2004 IJIR; (5) Chung E, et al: 2012 BJUI.
No one knows the answer to this question for sure. Some have suggested that the condition occurs following penile trauma (most often unrecognized microtrauma)(1) There may also be several sub-types of Peyronie's Disease, with some occurring directly from trauma, others from genetic predisposition, and yet others from the combination of erectile dysfunction and age (e.g. prostatectomy or diabetes)(Hypothesis).
References: (1) Rhoden EL, et al: 2010 J Sex Med.
As shown in the figure below, the typical age for Peyronie's Disease is 45-59 years old, with only about 10% of men being under 40 years of age.(1-6) This would suggest that in the majority of cases of young men with penile curvature, the condition may represent something other than Peyronie's Disease.
References: (1) Kadioglu, et al: 2002 J Urol; (2) Mulhall JP, et al: 2006 j urol; (3) Rhoden EL, et al: 2010 J Sex Med; (4) Grasso M, et al: 2007 Arch Esp Urol; (5) Deveci S, et al: 2007 J Sex Med; (6) Chung E, et al: 2012 BJUI.
The answer to this question depends on how you define Peyronie's Disease.
If you examine how many men over 18 years old had a diagnosis of Peyronie's Disease in their medical record, this rate would be 0.4-0.5%.(1-2) Using a similar database, if you sent a questionnaire to men and asked them if they had a Peyronie's Diagnosis, penile bump or plaque, penile curvature or deformity, or received treatment for Peyronie's Disease, 13% of men would meet this criteria.(2)
Other studies have reported rates ranging from 3.7-8.9% when older men were examined by Andrologists, Urologists, or Urology trainees.(3-5)
Specific subpopulations, including those who underwent a prostatectomy or those with diabetes and erectile dysfunction have rates as high as 15.9-20.3%.(6-7)
References: (1) Lindsay MB, et al: 1991 J Urol; (2) DiBenedetti DB, et al: 2011 Adv Urol; (3) Rhoden EL, et al: 2001 IJIR; (4) La Pera G, et al: 2001 Eur Urol; (5) Mulhall JP, et al: 2004 J Urol; (6) Tal R, et al: 2010 JSM; (7) Arafa M, et al: 2007 IJIR.
As noted above, Peyronie's Disease is a clinical diagnosis, meaning that there are not any blood tests or imaging studies that can be performed to confirm a diagnosis of Peyronie's Disease. There are also not any universally agreed upon criteria to diagnose Peyronie's Disease. Most often, men with Peyronie's Disease present with a palpable bump (plaque), penile pain, or penile deformity or curvature. Other common symptoms include decreased penile length, changes in penile sensation, and temporary or permanent erectile dysfunction. Men presenting with one or more of these symptoms may be classified as having Peyronie's Disease.
Men with lifelong penile curvature most likely do not have Peyronie's Disease but have congenital penile curvature.