Wednesday, July 4, 2007

The course of Peyronie's disease

This is just out: The natural history of Peyronie's disease. [Arch Esp Urol. 2007] - PubMed Result. I'll post later on how I get alerts about this kind of thing, but here are the key results from the study of 110 patients over at least five years (based only on the abstract):
1. Patients over 50 tend to stabilize or get better.
2. Patients under 50 tend to get worse. Almost 70% progressed to surgery.
Studies of the natural history of a disorder are hard to fund and hard to do. We need more of them. I don't know how good this one really is, the trick is how representative the initial sample is and how many are lost to follow-up. In general the patients who do worse tend to follow-up, so results of these studies tend to the "grim" side.

Grim is the word for the under-50 group, I really didn't think 70% would end up with surgery. Given that a significant number may have decided to give up on intercourse, it really contradicts the general impression most urologists have about the course of the disorder.

Conversely older patients can do well, though again I wonder how many just decide to give up.

Needless to say, no medical therapy seems to make any difference. Bad numbers, no doubt.

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