Korean J Urol.  2014 Jan;55(1):57-63. 10.4111/kju.2014.55.1.57.

Urologists' Perceptions and Practice Patterns in Peyronie's Disease: A Korean Nationwide Survey Including Patient Satisfaction

• Ko YH
• Moon KH
• Lee SW
• Kim SW
• Yang DY
• Moon DG
• Chung WS
• Oh KJ
• Hyun JS
• Ryu JK
• Park HJ
• Park K

• KMID: 1988454
• DOI: http://doi.org/10.4111/kju.2014.55.1.57

Abstract

PURPOSE
A nationwide survey was conducted of Korean urologists to illustrate physicians' perceptions and real practical patterns regarding Peyronie disease (PD).
MATERIALS AND METHODS
A specially designed questionnaire exploring practice characteristics and attitudes regarding PD, as well as patient satisfaction with each treatment modality, was e-mailed to 2,421 randomly selected urologists.
RESULTS
Responses were received from 385 practicing urologists (15.9%) with a median time after certification as an urologist of 12 years. Regarding the natural course, 87% of respondents believed that PD is a progressive disease, and 82% replied that spontaneous healing in PD occurred in fewer than 20% of patients. Regarding diagnosis of PD, the methods used were, in order, history taking with physical examination (98%), International Index of Erectile Function questionnaires (40%), intracavernous injection and stimulation (35%), and duplex sonography (28%). Vitamin E was most preferred as an initial medical management (80.2%), followed by phosphodiesterase-5 inhibitors (27.4%) and Potaba (aminobenzoate potassium, 20.1%). For urologists who administered intralesional injection, the injected agent was, in order, corticosteroid (72.2%), verapamil (45.1%), and interferon (3.2%). The most frequently performed surgical procedure was plication (84.1%), followed by excision and graft (42.9%) and penile prosthesis implantation (14.2%). Among the most popular treatments in each modality, the urologists' perceptions regarding the suitability of treatment and patient satisfaction were significantly different, favoring plication surgery.
CONCLUSIONS
The practice pattern of urologists depicted in this survey is in line with currently available Western guidelines, which indicates the need for development of further local guidelines based on solid clinical data.

Keyword

Data collection; Penile induration; Perception

MeSH Terms

4-Aminobenzoic Acid
Certification
Cyclic Nucleotide Phosphodiesterases, Type 5
Data Collection
Diagnosis
Electronic Mail
Humans
Injections, Intralesional
Interferons
Male
Patient Satisfaction*
Penile Implantation
Penile Induration*
Physical Examination
Potassium
Questionnaires
Transplants
Verapamil
Vitamin E
Vitamins
4-Aminobenzoic Acid
Cyclic Nucleotide Phosphodiesterases, Type 5
Interferons
Potassium
Verapamil
Vitamin E
Vitamins

Figure

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  FIG. 1 Urologists' perceptions regarding the suitability of treatment (A: 1, below 20%; 2, 20%-39%; 3, 40%-59%; 4, 60%-79%; and 5, over 80%) and patient satisfaction (B: estimated by 10 grades [0, no satisfaction; 10, full satisfaction]) with three common oral treatments used for Peyronie disease (PD). PDE-5, phosphodiesterase-5.

• 

  FIG. 2 Urologists' perceptions regarding the suitability of treatment (A: 1, below 20%; 2, 20%-39%; 3, 40%-59%; 4, 60%-79%; and 5, over 80%) and patient satisfaction (B: estimated by 10 grades [0, no satisfaction; 10, full satisfaction]) with three common intralesional injections used for Peyronie disease (PD).

• 

  FIG. 3 Urologists' perception regardingthe suitability of treatment (A: 1, below 20%; 2, 20%-39%; 3, 40%-59%; 4, 60%-79%; and 5, over 80%) and patient satisfaction (B: estimated by 10 grades [0, no satisfaction; 10, full satisfaction]) with three common surgical techniques used for Peyronie disease (PD).

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  FIG. 4 Urologists' perception regardingthe suitability of treatment (A: 1, below 20%; 2, 20%-39%; 3, 40%-59%; 4, 60%-79%; and 5, over 80%) and patient satisfaction (B: estimated by 10 grades [0, no satisfaction; 10, full satisfaction]) with the most popular methods in each modality among oral agents, intralesional injection, and surgery used for treatment of Peyronie disease (PD).

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