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Author Topic: Causes Vs Triggers Vs Risk Factors  (Read 4900 times)

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Hawk

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Causes Vs Triggers Vs Risk Factors
« on: August 29, 2012, 02:47:09 PM »

I was looking over this topic and see a need for some definitions that would bring much more clarity to the discussion.  I think it is important to distinguish between 3 separate but interrelated terms; causes, triggers, and risk factors.  If we a careless with the way we throw these terms around it confuses important aspects of the discussion not only for those of us that have been here a while but especially for newcomers.  We may intuitively know that rough masturbation could for trigger Peyronies Disease and that it is not a cause of Peyronies Disease but a newcomer reading a post may end up with misconceptions that remain for years if the wrong term is repeatedly used.

Diabetes, age, and prostatectomy, are all risk factors but they are not causes of Peyronies Disease.  Stress, or rough sex might trigger Peyronies Disease but they also are not causes.

Does anyone feel equipped to give a clinical definition of those three terms?  Rather than interject I will wait and see what we get.



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ashtown

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Re: Causes Vs Triggers Vs Risk Factors
« Reply #1 on: August 29, 2012, 03:19:37 PM »

To me this sounds like we could benefit from some input from a urologist who specialises in Peyronies Disease. It would probably be of benefit to all concerned if everybody had a clear idea of what these terms mean and when to use them.
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Hawk

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Re: Causes Vs Triggers Vs Risk Factors
« Reply #2 on: August 29, 2012, 07:59:36 PM »

The first two definitions are solid.  The only one that is somewhat vague to me is "cause".  I would like to see a better definition for this term.

Risk Factor: Something that increases a person's chances of developing a disease. For example, cigarette smoking is a risk factor for lung cancer, and diabetes is a risk factor for Peyronies Disease.

Trigger: Something that either sets off a disease in people who are genetically predisposed to developing the disease, or that causes a certain symptom to occur in a person who has a disease. For example, sunlight can trigger rashes in people with lupus.

Cause: Something that directly results in a disease or condition. 

In my mind, this would refers more to the underlying processes that actually result in the disease and that must be controlled or interrupted to prevent the disease.  Some risk factors and triggers are known for Peyronies Disease but there is only speculation and theory about the underlying cause.

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George999

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Re: Causes Vs Triggers Vs Risk Factors
« Reply #3 on: August 30, 2012, 10:03:18 AM »

Hawk,  I think the reason that "cause" is vague to you is that, as yet, there truly is no clear definition of the cause.  As you are well aware, I have a very defined theory as to what the "cause" is, and I believe I have a growing body of evidence.  But I would be the first to admit that evidence does not equal proof.  Additionally, plenty of acknowledged experts would dispute my theory.  But whether my theory holds water or not, there indeed must be an underlying "disease state" that makes some guys vulnerable to Peyronie's and others not, because it is very clear that many guys injure their penises severely and do NOT get Peyronie's as a result.  Additionally, of all the drugs that seem to "cause" Peyronie's, many guys take those same drugs for years and never get Peyronie's.  You name a "cause" and the story is the same.  That is why ALL of these "causes" that are proposed on this forum are not really causes, but actually triggers that unmask the underlying disease state.  I can sum all of that up this way:

The man did NOT bleed to death because he cut his finger, he bled to death because he had an underlying disease state - haemophilia.  Like the haemophiliac, we do not have Peyronie's because we injured our penises.  We have Peyronie's because we have an underlying disease state.  The difference is that unlike the haemophiliac, our underlying disease state is not fully understood or even identified to the satisfaction of the medical establishment as a whole.  Thus far there are only theories, some pretty good theories, but theories, none the less.

- George
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Hawk

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Re: Causes Vs Triggers Vs Risk Factors
« Reply #4 on: August 30, 2012, 10:32:21 AM »

George, they say "great minds run in the same channel" ;D 

Amazingly, I thought of the exact example that you used of the hemophiliac and started to type it but I wanted to come up with one I liked a little better but still have not found it.  The cause of the bleeding (to death) was hemophilia. The trigger to bleeding was the cut.  That translates to the reason for the bent penis is Peyronies Disease.  The trigger was the soccer ball trauma.  The risk factor was he was diabetic.  The cause of the Peyronies Disease or the hemophilia in our example are not even discussed.

To be clear, in this little thread I am not expecting to find the cause of Peyronies Disease or to list an example for the cause of Peyronies Disease but only to define the word cause in clear medical terms regardless of the disease.  I don't think it is synonymous with either risk factor or trigger.  I think my definition below however is lacking and needs to be more clear to draw the distinction with trigger and risk factor.
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james1947

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Re: Causes Vs Triggers Vs Risk Factors
« Reply #5 on: August 30, 2012, 05:54:27 PM »

I am jumping in with a little knowledge, but with own experience in the subject.

During the years, I had penis injuries from a kick during boxing (ones) and rough sex (a few times) so the trigger was there.
It didn't developed to Peyronies because I suppose I had no underlying disease state (risk factor?) at the time. ;D

Then, some four years ago from a new injury (from prostate shrinking procedure or from a new injury during sex, I am not sure, maybe both) I developed Peyronies. I suppose that in this case the underlying disease state was there already, but I really don't know what is my underlying disease state.  :(

James
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George999

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Re: Causes Vs Triggers Vs Risk Factors
« Reply #6 on: August 30, 2012, 08:39:31 PM »

but I really don't know what is my underlying disease state.  :(

NONE of us KNOW.  We do have theories, but to "know" implies that something is proven.  In the case of Peyronie's, nothing is really proven ... yet.  - George
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George999

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Re: Causes Vs Triggers Vs Risk Factors
« Reply #7 on: August 30, 2012, 08:56:41 PM »

To be clear, in this little thread I am not expecting to find the cause of Peyronies Disease or to list an example for the cause of Peyronies Disease but only to define the word cause in clear medical terms regardless of the disease.  I don't think it is synonymous with either risk factor or trigger.  I think my definition below however is lacking and needs to be more clear to draw the distinction with trigger and risk factor.

Hawk,  I really suspect that the huge problem with the term "cause" is that it is so relative.  "Risk factor" and "trigger" are very definitive and not at all relative, but "cause" is a whole different animal.  To flesh this out a bit more, realize that "cause" can carry an adjective.  For example, we can be talking about the ROOT cause ... or we can be talking about the IMMEDIATE cause.  We can even be talking about the INDIRECT cause and who knows how many more variations.  Thus the term "cause" itself is vague and not definitive at all.

The huge problem when one gets into things metabolic, is that there are often really no truly ROOT causes.  Disease states usually involve metabolic feedback loops where there are a whole string of things out of whack and trying to figure out which link failed first "THE cause" is next to impossible.  Additionally, genetics is guaranteed to be an underlying and complicating factor in any non-infectious disease state.  In the case of haemophilia, the genetic issue is quite clear and well understood.  In the case of Peyronie's, not so much.  And the genetic side comes in two major varieties, to complicate things further.  Some genetic issues (like haemophilia) are "hardcoded" into the genome.  Thus there is no known way to reprogram the defective genes.  In other cases, the problem is "soft coded" via epigenetic tagging.  In this case there ARE ways to recode the genome, although this is bleeding edge emerging science, and the specific genetic issues involved in Peyronie's are not even identified at this point.  All of this really complicates the concept of "cause" when it comes to Peyronie's or many other disease manifestations.

What is really frustrating is that so many of US make the mistake of taking a very simplistic view of the concept of "cause", which creates considerable confusion and in some cases leads to rabbit trails and a lot of wasted time and energy.  I use the term "US", because I myself confess to being part of this problem to some degree, since I have rather capriciously used the term "cause" before, myself.  There is this strange attraction in trying to identify THE cause, and that is not always helpful.
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james1947

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Re: Causes Vs Triggers Vs Risk Factors
« Reply #8 on: August 31, 2012, 06:14:07 AM »

Additionally, genetics is guaranteed to be an underlying and complicating factor in any non-infectious disease state.
For me the subject is clear, with evidence:
My father get Peyronies after surgery for enlarged prostate, at the age of 61.
I get Peyronies after TUNA treatment for enlarged prostate, at the age of 61.

James
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Got amazing support on the forum
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