Monday, December 3, 2007

Urologists - how they treat Peyronies Disease

Urologists are no more evidence based in their practice than most physicians ...
Urologist Practice Patterns in the Management of P...[J Sex Med. 2007] - PubMed Result

Introduction. Peyronie's disease (PD) is a poorly understood clinical entity. Aim. We endeavored to determine how contemporary urologists in the United States manage PD.

Methods. A randomly generated mailing list of 996 practicing urologists was generated from the American Urologic Association member directory. A specifically designed survey was mailed with a cover letter and a postage-paid return envelope. ...

...Results. Responses were received from 236 (24%) practicing urologists. Vitamin E was the preferred initial management for 70% of respondents, with observation, Potaba (Glenwood, Englewood, New Jersey, USA), colchicine, verapamil injections, and verapamil gel favored by 32, 20, 12, 7, and 10% of respondents, respectively. Fifty-seven percent of respondents performed surgery for PD, with penile prostheses, Nesbit procedure, grafting, and plication used by 76, 66, 55, and 51% of respondents, respectively. Medical therapy and/or observation was the preferred management for all of the cases except case 3, for which penile prosthesis placement and referral were the favored options by 39 and 30% of urologists, respectively...
Vitamin E does nothing and may have some toxicity in high doses. So it's unfortunate that 70% of urologists still use it. On the other hand, I suspect that the number would have been 90% a few years ago, so this probably is progress.

There's a bit more evidence for some other interventions, but none that I'm aware of for Potaba and precious little for cochicine.