Testosterone deficiency and Peyronie's disease: pilot data suggesting a significant relationship

As testosterone (T) has been shown to influence wound healing, and serum T declines in the age group at risk for Peyronie's disease (PD), we explored the possibility that low serum T may be associated with PD.

The purpose of this study was to evaluate the relationship between serum T concentrations and features of PD.

Medical records were reviewed for 121 consecutive patients with PD seen over a 2-year period. All patients were assessed for sociodemographic data, medical history, comorbid medical conditions, findings on physical examination, and severity of curvature. Laboratory testing included serum concentrations of total testosterone (TT) and free testosterone (FT). Testosterone deficiency (TD) was defined as TT values less than 300 ng/dL and/or FT less than 1.5 ng/dL.

Prevalence of TD in men with PD and correlation of TT and FT with severity of curvature and plaque size.

Mean patient age was 53.9 +/- 10.6 years (range 28-77). Penile curvature was 50.2 +/- 23.6 degrees (range 10-120). Mean TT was 411.6 +/- 203.6 ng/dL (range 69-877), and mean FT was 1.12 +/- 0.58 ng/dL (range 0.13-5.06). Low T was identified in 29.5% by TT alone and in 74.4% overall. Severity of curvature was greater for men with TD compared with men with normal T (54.3 vs. 37.1 degrees, P = 0.006). Men with low FT had greater penile curvature than men with normal FT (37.5 vs. 55.9 degrees, respectively, P = 0.003). Severity of penile curvature correlated significantly with FT (r = -0.314, P = 0.016) and estradiol/T (r = 0.476, P = 0.0001) but not TT (r = -0.199, P = 0.138).

This pilot study suggests a possibly important relationship between low T and PD. Further prospective studies are needed to confirm this relationship.