Urologists' Perceptions and Practice Patterns in Peyronie's Disease: A Korean Nationwide Survey Including Patient Satisfaction
Ko YH1, Moon KH1, Lee SW2, Kim SW3, Yang DY4, Moon du G5, Chung WS6, Oh KJ7, Hyun JS8, Ryu JK9, Park HJ10, Park K7. Korean J Urol. 2014 Jan;55(1):57-63. doi: 10.4111/kju.2014.55.1.57. Epub 2014 Jan 15.

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1Department of Urology, Yeungnam University College of Medicine, Daegu, Korea. 2Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 3Department of Urology, The Catholic University of Korea College of Medicine, Seoul, Korea. 4Department of Urology, Hallym University College of Medicine, Chuncheon, Korea. 5Department of Urology, Korea University College of Medicine, Seoul, Korea. 6Department of Urology, Ewha Womans University School of Medicine, Seoul, Korea. 7Department of Urology, Chonnam National University Medical School, Gwangju, Korea. 8Department of Urology, Gyeongsang National University School of Medicine, Jinju, Korea. 9Department of Urology, Inha University School of Medicine, Incheon, Korea. 10Department of Urology, Busan National University School of Medicine, Yangsan, Korea.

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.