Does testosterone deficiency exaggerate the clinical symptoms of Peyronie's disease?

Serum testosterone (T) influences wound healing and levels are decreased in the age group at risk of Peyronie's disease (PD). The aim of the present study was to evaluate the severity of penile deformity in men with PD in relation to T levels. One-hundred and six patients with PD and T deficiency (serum T <3.5 ng/mL; Group 1) and those with normal T levels (Group 2) were compared according to the duration of PD, the size and location of the plaques, penile curvature, pain on erection, and the severity of erectile dysfunction. The mean degree of penile curvature in Group 1 was significantly greater than in Group 2 (32.0 ± 15.9° vs 21.8 ± 15.4°, respectively). The mean Group 1 score on the International Index of Erectile Function (IIEF)-5 was lower than the score for Group 2 (7.4 ± 3.7 vs 10.8 ± 4.8, respectively). The percentage of patients who complained of pain on erection did not differ between the two groups. Plaque size in Group 1 was larger than in Group 2 (3.0 ± 1.2 vs 2.0 ± 1.2 cm, respectively), whereas there was no significant difference in plaque location. Although there was a lower percentage of responders to medical treatment in Group 1, there were no differences in surgical outcomes between the two groups. These findings suggest that the presence of T deficiency in patients with PD exaggerates the severity of PD by affecting penile deformity, plaque size, and erectile dysfunction. Further studies are needed to confirm this relationship.