I've been thinking about the results of a very recent study of the natural history of Peyronie's Disease. I'm thinking the study suggests that there may be two types of Peyronie's disease, early onset (Type I?) and late onset (Type II?) with an age cutoff of 50.
Fifty is a special age. Throughout most of human evolution men did not live past fifty. Nothing is really designed to last that long; life much past fifty requires a cozy environment and, often, some medical care. So things that go wrong after fifty are often normal "wear and tear". That's a clue.
My guess is that Peyronie's after 50 is mostly a bit of bad luck. The course of late onset Peyronie's is relatively benign. Progression is limited. Symptoms may resolve. It sounds more like an unlucky tear or injury to a sub-optimal tunica albuginea than a true disease. It's a vulnerable structure, sometimes it's less well made, it can tear.
Early onset Peyronie's, developing before age 50, is another story. The disease seems to progress, and may do so without evidence of repeated trauma. This seems more like a pathologic process, a genetic disorder of fibrocyte perhaps.
They may be the same condition of course, or related conditions, but I suspect we'll learn more about Peyronie's if we study early onset and late onset disease separately. If we study them together, we may miss important signals in the noise.
3 comments:
Could it be physiological changes associated with aging may actually suppress the formation of Peyronie's lesions? What is either present or absent in a 50+ year old male that is not in a younger male? First thought is to look at hormone levels.
I will be 51 in December this year, and contracted Peyronie's within the past 2 months. I am as convinced as I can be that the cause in my case was the taking of high dosage Vitamin C supplements (1g daily) during the previous 12 months. I have none of the usual indications for Peyronie's - I don't smoke or drink, am fit and in good condition for my age, do not suffer from Diabetes and am not overweight. I also do not suffer from Dupuytren’s, and there is no history to my knowledge of either Dupuytren’s nor Peyronie's in my family.
Vitamin C is directly linked to the synthesis of collagen though, and it is logical to assume that very high dosage Vitamin C supplement intake is likely as a result to significantly increase collagen production, perhaps resulting in over-production making the subject an increased risk for Peyronie's.
The only other risk factors I can think of are overwork, resultant sleep deprivation and occasional work-related high levels of stress (I tend to thrive on stress though, even to an extent getting "high" on resultant adrenaline level increase, so am not certain that is a potential risk factor for Peyronie's).
I do not indulge in rough sex, nor have experienced any penile trauma to my knowledge likely to be the cause of Peyronie's.
You make a lot of sense, Doc. My curvature developed in my mid 60s following a month of catheter use. I was a straight as an arrow for 65 years, then I developed a sharp downturn. That lasted for 5 years, then it straightened out for a couple if months, then it started to turn upward. Now it's a bit shorter and curved up. It's quite weird. I believe that my Peyronies is the result of catheter damage and age. Type Ii, as you say. I keep an eye on it should it decide to assume another shape
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