Evaluating treatment pathways for Peyronie’s disease utilizing the TriNetX research registry

Peyronie’s disease (PD) is a fibrosing condition that affects the penis which leads to pain, curvature, sexual dysfunction, and psychological bother. Our retrospective cohort analysis aims to evaluate the current treatment pathways utilized for PD. We queried the TriNetX database for all adult men (≥18 years) with PD using the International Classification of Diseases-10 (ICD-10) code, N48.6, from the years 2003–2023. All interventions associated were assessed using Current Procedural Terminology (CPT) and Medical Prescription Normalized (RxNorm) codes. These included injection therapy, penile plication, plaque excision ± grafting, penile implant, and oral pentoxifylline. Of the 51011 PD cases identified, observation was the most common management (72.1%, n = 36 787). Pentoxifylline (70.0%, n = 4 699) was the most used single medical treatment followed by injection therapy (30.0%, n = 2 012). Penile plication was the most performed surgery for PD (55.1%, n = 1 793). Among patients who underwent multiple therapies (30.0%, n = 4 261), a progression of medical to surgical treatment only occurred in 24.5% (n = 1 044). PD is predominantly managed with observative measures, followed by medical therapy, and surgery. Surgical therapy occurred less frequently after medical treatment suggesting that few patients are interested in or may have limited access to a stepwise approach for the treatment of PD.