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Tim468

<1>
UI 20059657
AU Alphs HH.  Navai N.  Kohler TS.  McVary KT.
FA Alphs, Hannah H.  Navai, Neema.  Kohler, Tobias S.  McVary, Kevin
 T.
IN Department of Urology, Northwestern University Feinberg School of
 Medicine, Chicago, IL60611-3008, USA.
TI Preoperative clinical and diagnostic characteristics of patients
 who require delayed IPP after primary Peyronies repair.
SO Journal of Sexual Medicine.  7(3):1262-8, 2010 Mar.
AB INTRODUCTION: Penile vascular abnormalities occur in a high
 proportion of patients with Peyronie's disease (Peyronies Disease). Penile duplex
 ultrasonography (PDU) and dynamic infusion cavernosometry and
 cavernosography (DICC) are tools that can be used to help tailor
 individualized treatment for patients undergoing surgical
 intervention for their Peyronies Disease. However, precisely which parameters can
 be used to predict those patients with Peyronies Disease at risk for developing
 erectile dysfunction (ED) after intervention without inflatable
 penile prosthesis (IPP) has not been previously elucidated. AIM: To
 evaluate preoperative vascular parameters that predispose Peyronies Disease
 patients for developing ED after intervention without IPP. METHODS:
 Twenty-six patients receiving surgical intervention for their Peyronies Disease at
 a single center were retrospectively identified. Of these, 11
 (42.3%) opted for primary repair without placement of an IPP. Three
 (27.2%) of these 11 patients went on to develop ED postoperatively.
 MAIN OUTCOME MEASURES: We compared various demographic, PDU, and
 DICC parameters between patients who did and did not fail primary
 repair of their Peyronies Disease. RESULTS: Mean age and follow-up of patients who
 went on to develop ED after repair of Peyronies Disease without IPP were not
 significantly different (P < 0.05). Resistive index (RI) and end
 diastolic volume were significantly different between these two
 groups (P < 0.05), while peak systolic volume, flow to maintain, and
 pressure decay were not significantly different. An RI cutoff of
 <0.80 was found to identify all patients who would later develop ED
 and fail primary repair without IPP. CONCLUSIONS: Penile vascular
 assessment can aid in counseling patients about their risk of
 developing delayed ED after primary repair of Peyronies Disease. In our cohort of
 patients, PDU provided preoperative risk stratification for
 postoperative erectile dysfunction in men undergoing Peyronie's
 repair without IPP. We propose the prospective study of an RI cutoff
 to identify patients at risk of failing primary Peyronies Disease repair without
 IPP.
PT Journal Article.

<2>
UI 20500447
AU Tal R.  Heck M.  Teloken P.  Siegrist T.  Nelson CJ.  Mulhall JP.
FA Tal, Raanan.  Heck, Matthias.  Teloken, Patrick.  Siegrist,
 Timothy.  Nelson, Christian J.  Mulhall, John P.
IN Urology Service, Department of Surgery, Memorial Sloan-Kettering
 Cancer Center, New York, NY, USA.
TI Peyronie's disease following radical prostatectomy: incidence and
 predictors.
SO Journal of Sexual Medicine.  7(3):1254-61, 2010 Mar.
AB INTRODUCTION: Both prostate cancer and Peyronie's disease (Peyronies Disease)
 are prevalent in men after their fifth decade of life. The evidence
 to support or refute a link between radical prostatectomy (RP) and
 Peyronies Disease is limited. AIMS: To define the incidence of Peyronies Disease in men who had RP
 and determine possible predictors of Peyronies Disease development after RP.
 METHODS: A review of a prospectively built sexual medicine database,
 years 2002-2008, looking at subjects who had RP as a monotherapy for
 localized prostate cancer. We identified and characterized subjects
 who developed Peyronies Disease within 3 years after RP and compared them with
 subjects who did not. MAIN OUTCOME MEASURES: The incidence of Peyronies Disease
 among men who attended a sexual medicine clinic after they had RP,
 predictors of Peyronies Disease development after RP. RESULTS: The study population
 included 1,011 subjects, and Peyronies Disease incidence in this population was
 15.9%. Mean time to develop Peyronies Disease after RP was 13.9 +/- 0.7 months.
 Mean curvature magnitude was 31 + 17 degrees. On univariate
 analysis, younger age (mean age of 59 + 7 in men with Peyronies Disease vs. 60 + 7
 years in men without Peyronies Disease, P = 0.006) and white race (vs non-white,
 18% vs. 7%, P < 0.001) were predictive of Peyronies Disease development after RP,
 but post-op erectile function was not a predictor of Peyronies Disease development.
 On multivariate analysis, younger age (odds ratio (OR) = 1.3, for
 5-year decrease in age) and white race (OR = 4.1, vs. non-white)
 remained independent significant predictors. CONCLUSIONS: Men
 presenting with sexual dysfunction after RP have higher Peyronies Disease incidence
 then the general population. Therefore, they should be routinely
 evaluated for Peyronies Disease. Younger men and men of white race are at increased
 risk for Peyronies Disease. Prospective controlled studies are needed to elucidate
 the incidence of Peyronies Disease following RP and to conclude if RP has a
 causative role in the pathogenesis of Peyronies Disease.
PT Journal Article.  Research Support, Non-U.S. Gov't.

Tim
52, Peyronies Disease for 30 years, upward curve and some new lesions.