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PROSTATE CANCER AND PEYRONIES

Approximately one year ago, I started to notice medical
journal articles linking PD and treatment for prostate cancer,
primarily Radical Prostatectomies.  Both men with PD and
related adverse reaction, i.e. decrease in penile dimensions.  
Even more disturbing was the finding that men who sought
treatment for prostate cancer were unaware of these
treatment side effects. This was due either to their physician’s
lack of knowledge or the patient's own failure to pay
appropriate attention to the pre-treatment discussion. Finally,
I have also discussed men’s mistaken impression that
minimally invasive or robotic-assisted laparoscopic
prostatectomies are far superior in terms of post operative
sexual functioning as compared to the open prostatectomy,
an older procedure.  

Currently, there have been many articles confirming these
findings. They are now generally accepted as fact.

Let us review each of the issues above and cite just some of
the research findings.

1.Patients are unaware of post- surgical outcomes

  • Modern Medicine August 01, 2009.  Almost none of the
    patients understand that there will be documented
    orgasm changes.  They think they are going to get back
    to the way they were prior to surgery, but this is just not
    true.  Many will have sexual dysfunction, including
    Peyronies Disease.  Physicians need to develop a
    structured pretreatment protocol.

2.There are adequate findings to document that newer
surgical techniques are superior to more established
procedures

  • New York Times, October 14, 2009.  Dr. Hu, director of
    Urologic Surgery at a Boston Hospital. “People intuitively
    think that the minimally invasive approach has few
    complications, even in the absence of data.”  Men who
    had minimally invasive surgery were at greater risk of
    incontinence and erectile dysfunction as compared to
    open surgery.   

3. A radical prostatectomy leads to an increase in the
incidence of PD

  • Most recent and important finding for men whose primary
    interest is PD. Urology Service, Department of Surgery,
    Memorial Sloan-Kettering Cancer Center, June 17, 2010.
    The study reviewed a prospectively built sexual medicine
    database, years 2002-2008, for men who underwent
    surgical removal of the prostate.  This study included
    1,011 patients and the PD incidence was 15.9% vs 3.2-
    8.9% in the general male population.  Mean time to
    develop PD was approximately 13.9 months with younger
    age at the time of surgery a significant predictor for PD
    development.  An editorial in UroToday, July 22, 2010,
    comments upon the previous cited research study.   
    “Peyronies Disease occurs more frequently following a
    radical prostatectomy than it does among men in the
    general population…”  Patients who were in the study had
    only surgery and no other salvage therapy.  Nerve
    sparing surgery was not an independent predictor of
    Peyronies development.  

4. Decreased penile dimension and PD following a radical
prostatectomy.  

  • Current Urology Report, 2009 November.  The majority of
    men undergoing a radical prostatectomy for prostate
    cancer have a measured loss of penile length, which can
    also occur with PD and maybe exacerbated by surgery.  
    This article omitted the issue of decreased circumference,
    also a common adverse event  

This website is about PD.  However, since my feedback
indicates that prostate issues are of great importance to my
audience and there is a relationship to Peyronies Diseaase, I
am going to continue with prostate news.  The feed lower
down on this page will contain prostate news and be almost
updated daily.  Be patient, it takes about 15 seconds for it to
begin scrolling.