PD

Question 1

What history must you elicit for PD?

Answer 1

onset, degree of curvature, pain with erection, pain without erection, is it worsening, prior treatments, any deformity such as hourglass / hinge, sexual function, degree of bother

Question 2

What to do on physical exam?

Answer 2

palpate for plaque, stretch penis, identify area of maximal curvature, area of tenderness

Question 3

Do you need to do an ICI test?

Answer 3

YES
Can consider photos for those that do not want to, but cannot have a deformity

Question 4

What is treatment for active PD?

Answer 4

NSAID

Question 5

What are restrictions of xiaflex?

Answer 5

between 30 and 90 degrees, stable / chronic disease, no severe ED, and modeling can be offered

Question 6

What was degree curvature improvement in IMPRESS trials, and how many?

Answer 6

mean 17 degrees improvement, 34% overall
PDQ scores improved versus placebo
(between placebo and injection, only about 8 degrees, but statistically significant)

Question 7

What are adverse events with xiaflex?

Answer 7

penile pain, hematoma, infection, penile fracture (0.5%), bruising, swelling, blood blister, dyspareunia,

Question 8

What are other injectable options?

Answer 8

Interferon 2a injections or verapamil

Question 9

What are the AE of interferon 2a injections?

Answer 9

sinusitis, flu-like symptoms, minor penile swelling

Tx with NSAIDs

Question 10

What are the AE of verapamil injections?

Answer 10

bruising, dizziness, pain, nausea

Question 11

What are potential AE of plication?

Answer 11

hematoma, penile pain, shortening, skin necrosis, painful suture, urethral injury, UTI