Association between Peyronie disease and low serum testosterone levels: detection and therapeutic considerations.

The aim of this paper was to find a link between Peyronie disease (PD) and bioavailable testosterone (bT)/free testosterone (fT) blood levels. Subjects with no erectile dysfunction were prospectively studied with respect to 3 parameters: differences in bT/fT between 106 PD patients and 99 healthy controls; differences in plaque area, penile curvature, and pain between 54 PD patients with low bT/fT and 52 PD patients with normal bT/fT; and differences in intraplaque verapamil efficacy between 20 hypogonadal PD patients supplemented with testosterone and 23 hypogonadal PD patients administered a placebo. Medical history, objective examination, and dynamic duplex scanning of the penis, both before and 8 months after the end of the therapy (ie, at the end of the study period), were used to assess PD. Testosterone supplementation was carried out with testosterone buccal adhesive patches 2 × 30 mg/d for the entire study period. bT and fT were significantly lower in PD patients than in control patients. The plaque area was significantly higher in PD patients with low bT/fT than in patients with normal bT/fT. No significant difference emerged when pain or penile deformity were examined. Plaque area and penile curvature improved to a greater extent when intraplaque verapamil injections were associated with testosterone administration than when associated with a placebo. Men with PD had lower bT/fT than healthy controls. In these patients, supplementation with testosterone improved the efficacy of intraplaque verapamil. Plaque area and penile curvature were more severe in hypogonadal PD.