A MSKCC Study on Peyronies and RP

Article is here: Peyronie’s Disease As Side Effect of Prostate Surgery

The study said...
In the authors’ study, they found a 15.9 percent incidence of Peyronie’s disease among men who sought sexual medicine care after radical prostatectomy. The study did not, however, identify men who did not seek help at the sexual medicine program at Memorial Sloan-Kettering.

Even so, the investigators stated that the prevalence of Peyronie’s disease after radical prostatectomy is high among men who ask for help with sexual dysfunction and physicians should make efforts to diagnose it, as medical treatment may be more effective in the initial stage of Peyronie’s disease. Delaying diagnosis may reduce a man’s chances of responding positively to nonsurgical treatment.

However, because men who have had a prostatectomy often experience erectile dysfunction, Peyronie’s disease can be missed. The penile deformity characteristic of Peyronie’s disease is sometimes first noticed after men use intracavernosal injection therapy to achieve a rigid erection. Even then, men tend to associate use of the injection with the curvature, although there is no evidence intracavernosal injections cause Peyronie’s disease.
- See more at: http://www.prostate.net/2011/erectile-dysfunction-impotence/peyronies-disease-side-effect-of-radical-prostatectomy-prostate-cancer-treatment/#sthash.4Bvv00he.dpuf

MSKCC is where Dr John Mulhall works. I haven't tracked down the study referenced in the article but it is highly likely that Mulhall is one of the authors. He has treated several members here for Peyronie's and he has consistently told them he doesn't think injections cause it.

If you look at how Peyronie's is diagnosed you will find that it often involves intercavernous injections to reveal the extent of the problem. So the theory that injections reveal, rather than cause, the problem is not irrational on the face of things.

By the way, if you go to Dr. Mulhall for treatment of Peyronie's, one of the first things they do is give an injection to cause an erection so they can measure the direction and magnitude of the curvature. There's just no other way to assess the extent of the Peyronie's as far as I can tell. I presume other uros who have expertise in Peyronie's do the same.

-Gedman

Does insulin resistance or pre-diabetes or diabetes predispose to Peyronie's? Especially if combined with decreased penile nitric oxide production such as we all experience after RP? Does hyperglycemia promote penile fibrosis? I'm not sure I am interpreting this study correctly so Y'all have a look:

http://www.ncbi.nlm.nih.gov/pubmed/20626593
"The antifibrotic, antioxidative, and SM-protective roles of iNOS in the penile corpora cavernosa were confirmed in the iNOS KO/STZ mouse model. These findings support the importance of endogenously-elicited iNOS induction in protecting the penile corpora cavernosa from the pro-fibrotic effects of hyperglycemia."

What about low or high androgens?
http://www.ncbi.nlm.nih.gov/pubmed/20584122
"Our findings suggest that decreased levels of adrenal androgens may be implicated in the pathogenesis of PD. The mechanism and clinical relevance of this observation remain to be established."