Survey results make case for establishing Peyronie's guidelines

Results of a survey of Peyronie's disease knowledge and practice patterns among urologists in the United States raise concernsand speak to the need for developing Peyronie's disease guidelines, John P. Mulhall, MD, said at the AUA annualmeeting.

The survey, developed by Dr. Mulhall, of Weill Medical College of Cornell University, and Laurence A. Levine, MD, Universityof Illinois, Chicago, was a 46-item questionnaire e-mailed to AUA members. There were 639 respondents.

The results showed that a large portion of the respondents consider themselves experts in sexual medicine (40%), although only9% were members of the Sexual Medicine Society of North America (SMSNA), and the majority saw fewer than five Peyronie's patients permonth.

Responses to questions about Peyronie's prevalence and natural history showed gaps in basic knowledge. Urologists' responsesindicated that while, initially, most prefer to take a conservative approach to managing Peyronie's, the vast majority performsurgery for the disease.

Vitamin E was the most commonly used oral agent, 27% of respondents used transdermal verapamil, and 45% performedintralesional therapy.

"The findings on PD knowledge, and especially those that show many urologists are operating on patients despite seeing veryfew patients, are somewhat concerning," Dr. Mulhall said. "PD patients are very litigious, and this is not the kind of surgeryurologists should be performing on an occasional basis.

"Although there is a paucity of evidence-based medicine in this area, I think there is an onus on the AUA and the SMSNA tobegin this project to help practicing urologists conduct rational management of PD that will provide patients with realisticexpectations about their condition and have an impact on the course of their disease."