Objective: To investigate the association between serum testosterone levels and the severity of penile curvature and plaque size in men with Peyronie's disease (PD).
Materials and Methods: This retrospective cross-sectional study included 108 men diagnosed with Peyronie’s disease who presented to our urology outpatient clinic between January 2022 and July 2025. Patients with prior testosterone replacement therapy, pelvic surgery, intralesional treatment, or systemic conditions affecting testosterone metabolism were excluded. Demographic and clinical data—including disease duration, penile pain, erectile dysfunction (assessed by IIEF-5), and disease phase—were recorded. Penile curvature was assessed via self-photographs during natural or pharmacologically induced erections, and plaque size was measured ultrasonographically. Fasting morning serum samples were analyzed for total testosterone (TT), free testosterone (FT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, and metabolic parameters.
Results: Mean age was 59.6 ± 7.5 years, and mean disease duration was 22.7 ± 29.4 months. Mean horizontal and vertical curvatures were 12.1 ± 19° and 28.5 ± 19.8°, respectively. Mean plaque size was 8.9 ± 7 mm. No significant differences were observed between hypogonadal and eugonadal groups in curvature severity (p>0.05), plaque size (p=0.54), or disease phase. Hypogonadal men had significantly lower SHBG and estradiol levels and higher HbA1c and triglyceride values (all p<0.05). No correlations were found between testosterone levels and curvature degree or plaque dimensions.
Conclusion: Serum testosterone levels are not associated with PD severity. Hypogonadism appears to be a comorbidity rather than a determinant of disease severity, suggesting routine testosterone evaluation may not be necessary in PD management.
Keywords: Peyronie’s disease, penile curvature, penile plaque, testosterone levels
Abstract
Objective: To investigate the association between serum testosterone levels and the severity of penile curvature and plaque size in men with Peyronie's disease (PD).
Materials and Methods: This retrospective cross-sectional study included 108 men diagnosed with Peyronie’s disease who presented to our urology outpatient clinic between January 2022 and July 2025. Patients with prior testosterone replacement therapy, pelvic surgery, intralesional treatment, or systemic conditions affecting testosterone metabolism were excluded. Demographic and clinical data—including disease duration, penile pain, erectile dysfunction (assessed by IIEF-5), and disease phase—were recorded. Penile curvature was assessed via self-photographs during natural or pharmacologically induced erections, and plaque size was measured ultrasonographically. Fasting morning serum samples were analyzed for total testosterone (TT), free testosterone (FT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, and metabolic parameters.
Results: Mean age was 59.6 ± 7.5 years, and mean disease duration was 22.7 ± 29.4 months. Mean horizontal and vertical curvatures were 12.1 ± 19° and 28.5 ± 19.8°, respectively. Mean plaque size was 8.9 ± 7 mm. No significant differences were observed between hypogonadal and eugonadal groups in curvature severity (p>0.05), plaque size (p=0.54), or disease phase. Hypogonadal men had significantly lower SHBG and estradiol levels and higher HbA1c and triglyceride values (all p<0.05). No correlations were found between testosterone levels and curvature degree or plaque dimensions.
Conclusion: Serum testosterone levels are not associated with PD severity. Hypogonadism appears to be a comorbidity rather than a determinant of disease severity, suggesting routine testosterone evaluation may not be necessary in PD management.
Keywords: Peyronie’s disease, penile curvature, penile plaque, testosterone levels