Peyronie's disease in the United States: A real‐world, 13‐year nationwide analysis of demographics, clinical characteristics, and treatment trends

Abstract

Background

Real‐world data on Peyronie's disease remains limited.

Objectives

Describe the demographics, clinical characteristics, and therapeutic management of Peyronie's disease patients in the United States.

Materials and methods

A retrospective analysis was conducted using the PearlDiver Mariner database (2010–2022). Male adults with Peyronie's disease were identified using the International Classification of Diseases codes. Data included demographics, clinical conditions, and treatments. Analysis was performed using R‐based software.

Results

Among 176,969 patients (mean age 58.9 years), hypertension (72.9%), diabetes (40.4%), and obesity (31.1%) were the most common comorbidities. Smoking was prevalent in 41.5%. Dupuytren's contracture affected 3.1%, penile trauma 0.2%, erectile dysfunction 28.2%, and depression 19%. Most patients were from the southern US (42.9%). Social determinants of health were noted in 30.9%.

Treatment was received by only 13.2%. Intraplaque injections were the most frequent therapy (7.2%) and showed an increasing trend (p = 0.014). Surgical interventions (8.1%) included plication (35.1%), grafting (13%), prosthesis implantation (36.2%), and multiple techniques (15.7%). Grafting was linked to higher de novo erectile dysfunction risk.

Discussion

Hypertension, diabetes, and smoking are frequent among Peyronie's disease patients. Erectile dysfunction and depression are common within a year of diagnosis. Despite multiple treatment options, only 15% of patients receive therapy. Injections are increasingly preferred, while surgery remains underutilized. Inflatable prostheses are the favored option for prosthetic management.

Conclusion

Peyronie's disease patients often have significant comorbidities. Treatment rates are low, with injections as the most used therapy. Surgical interventions are less common, with stable trends over time.

1. INTRODUCTION

Peyronie's Disease (PD) is an acquired connective disorder characterized by the formation of fibrous plaques within the tunica albuginea of the penis, typically resulting in penile curvature. ¹ This condition affects approximately 0.4%–9% of men, though true prevalence may be higher due to underreporting, which could be related to the embarrassment associated with the symptoms. ² , ³ The pathophysiology of PD is not fully understood, but it is thought to stem from repetitive microvascular trauma to the penile shaft, which leads to aberrant wound healing and plaque formation. ⁴ , ⁵ PD is characterized by an initial acute inflammatory phase, marked by the development of penile curvature and sometimes penile pain, which can last for up to 12–18 months. This is followed by a chronic phase, during which the curvature stabilizes, and pain disappears. ⁶ PD is often associated with erectile dysfunction (ED) and psychological distress, with profound repercussions on the quality of life of affected men. ⁷ , ⁸

Treatment options for PD range from conservative to surgical interventions. ⁹ , ¹⁰ Conservative treatments include analgesics, shockwaves, devices for penile modeling, and intralesional injections. Several agents have been proposed for injection therapy both in the acute and chronic phase, often with heterogeneous results. Verapamil, interferon, corticosteroids, collagenase Clostridium histolyticum (CCH), hyaluronic acid, and platelet‐rich plasma (PRP) are some relevant examples. ¹¹ , ¹² Importantly, CCH is currently the only FDA‐approved injection therapy for PD. Surgery remains the therapy of choice during the chronic phase in patients with significant penile deformity or ED. Different techniques such as penile plication, plaque incision/excision and grafting, or penile prosthesis implantation can be offered to PD patients. A surgical approach is selected based on the severity of curvature, penile length, presence of complex deformities, erectile function, and patient preference. ¹³ , ¹⁴ , ¹⁵

While several observational studies and clinical trials have explored the epidemiology and treatments of PD, large‐scale real‐world data reflecting current patient characteristics and clinical practice remain scarce. Addressing this gap could enhance clinical decision‐making and guide future research.

The aim of this study was to describe the demographics, clinical characteristics, and therapeutic management of patients with PD in the United States based on a large nationwide database.

2. MATERIALS AND METHODS

2.1. Study design and data source

We conducted a retrospective analysis in December 2023 using the PearlDiver Mariner database (PearlDiver Technologies). It is a commercially available, all‐payer claims, deidentified, national database. It encompasses comprehensive claims data from Medicare, Medicaid, and private insurance across all US territories. PearlDiver Mariner currently contains over 41 billion Health Insurance Portability and Accountability Act (HIPAA)‐compliant patient records collected between 2010 and 2022. Based on the study design and data source, this research was deemed exempt by the Institutional Review Board.

2.2. Codes and extracted data

International Classification of Diseases Ninth and Tenth Editions (ICD‐9 and ICD‐10), Current Procedural Terminology (CPT), and Mariner Uniform System of Classification codes were used to identify the required data in the PearlDiver Mariner database. All codes were selected by two authors independently (Eugenio Bologna and Celeste Manfredi), while a third senior author (Riccardo Autorino) resolved any disagreements. CPT codes were preferred to ICD codes for identifying PD treatments because they were more specific and therefore associated with a lower risk of error. All codes used are summarized in Table S1.

Adult male patients diagnosed with PD were selected using the specific ICD codes ICD‐9‐D‐607.85 or ICD‐10‐D‐N48.6. We employed a “first instance” filter to include only the initial diagnosis entries, excluding any prior PD diagnosis, to ensure assessment of initial therapeutic approaches. Demographic and clinical characteristics were reported for the entire cohort of PD patients and a subset was compared across the treatment groups. Variables collected were the following: region, insurance plan, social determinants of health (SDOH), age, region, Charlson Comorbidity Index (CCI), obesity, diabetes mellitus, hypertension, smoking, history of penile trauma, Dupuytren's contracture, congenital penile curvature (CPC), diagnosis of ED, phosphodiesterase‐5 inhibitors (PDE5Is) intake, depressive symptoms. Due to the absence of specific codes, the treatments of PD investigated were limited to intraplaque injections, penile plication, grafting, and penile prosthesis implantation. Data on the agent injected or the type of plaque surgery or grafting used were not available. Possible multiple treatments (simultaneous or in successive stages) were reported. Time from PD diagnosis to treatment was also recorded.

2.3. Statistics

All statistical analyses were performed using the software (i.e., Bellwether) integrated into the PearlDiver Mariner database, based on the R language. Kolmogorov‐Smirnov test was applied as normality test. Quantitative variables were reported as means and standard deviations (SDs), while qualitative variables were described as absolute and relative frequencies. Mann‐Kendall test was used to analyze the treatment trends. One‐way analysis of variance and Chi‐squared test were applied to assess differences in continuous and categorical variables, respectively, across the various treatment groups. Bonferroni adjustment for multiple comparisons was performed where necessary to maintain statistical integrity. Additionally, a multivariable logistic regression analysis was conducted to identify predictors of surgical treatment or de novo ED after diagnosis of PD. The selection of independent variables for logistic regression analysis was conducted a priori, guided by theoretical considerations and evidence from the existing literature; this approach was chosen to minimize the risk of overfitting and to increase their generalizability. The results of the logistic regression analysis were reported as odds ratios (ORs) and 95% confidence intervals (CIs). All p‐values were two‐tailed, with significance arbitrarily defined as p < 0.05.

3. RESULTS

3.1. Demographics and clinical characteristics of PD patients

A total of 176,969 men with a new diagnosis of PD were identified. The mean (SD) age at diagnosis was 58.92 (11.29) years. The most common recorded comorbidity was hypertension (72.93%), followed by diabetes (40.44%) and obesity (31.14%). Smokers constituted 41.53% of the patients. A Dupuytren's contracture was reported in 3.10% of cases. Only 0.02% of men with PD had a CPC. A penile trauma before the diagnosis of PD was described in 0.20% of subjects, with a mean of 644 days between the two events. ED at diagnosis was found in 28.23% of patients, while depressive symptoms were detected in 18.97% of cases within one year of diagnosis. Most patients with PD were diagnosed in the southern regions of the U.S. (42.9%) and had a commercial insurance plan (77.0%). SDOH was identified in 30.95% of the cohort, indicating that nearly one‐third of patients had documented issues related to SDOH. Demographic and clinical characteristics are detailed in Table 1.

TABLE 1.

Demographics and Clinical characteristics of patients with Peyronie's disease (PD) (n = 176,969).

Variable	Value
Age, mean (SD) years	58.92 (11.29)
CCI, mean (SD)	3.37 (2.51)
Obesity, n (%)	55,110 (31.14)
Diabetes, n (%)	71,568 (40.44)
Hypertension, n (%)	129,068 (72.93)
Smoking, n (%)	73,496 (41.53)
Penile trauma, n (%)	348 (0.20)
Dupuytren's contracture, n (%)	5480 (3.10)
CPC, n (%)	36 (0.02)
ED at PD diagnosis, n (%)	49,950 (28.23)
Depression within 1 year of PD diagnosis, n (%)	33,578 (18.97)
Region, n (%)
Midwest	40,387 (22.82)
Northeast	35,689 (20.17)
South	75,914 (42.9)
West	24,275 (13.72)
Not specified	705 (0.40)
Insurance plan, n (%)
Cash	175 (0.10)
Commercial	136,261 (77.00)
Government	2552 (1.44)
Medicaid	5676 (3.21)
Medicare	29,350 (16.58)
Unknown	1683 (0.95)
NA	1270 (0.72)
SDOH, n (%)	54,768 (30.95)

Abbreviations: CCI, Charlson Comorbidity Index; CPC, congenital penile curvature; ED, erectile disfunction; NA, not available; PD, Peyronie's disease; SD, standard deviation; SDOH, social determinants of health.

3.2. Treatment strategies for PD

A total of 23,368 (13.2%) patients with PD received at least one identifiable treatment. Intraplaque injections were performed on 12,755 men (7.21%), making it the most common therapy for PD. Following the injections, 28.71% of these men also underwent surgery. A surgical treatment was described in 14,275 (8.07%) subjects with PD. Grafting, penile plication, or penile prosthesis alone was reported in 12.97%, 35.12%, and 36.2% of individuals undergoing surgery, respectively. Multiple surgical treatments were performed in the remaining 15.7% of patients undergoing surgery (Figure 1 and Table 2).

FIGURE 1.

Distribution of treatments for PD performed in the United States from 2010 to 2022. PD, Peyronie's disease.

TABLE 2.

Treatment strategy for Peyronie's disease (PD) (n = 176,969).

Intraplaque injections, n (%)	12,755 (7.21) a
Intraplaque injections (only)	9093 (71.29) b
Intraplaque injections + surgery	3662 (28.71) b
Surgery, n (%)	14,275 (8.07) a
Surgery (only)	10,613 (71.29) b
Surgery + intraplaque injections	3662 (28.71) b
Grafting (only)	1852 (12.97) c
Penile plication (only)	5014 (35.12) c
Penile prosthesis (only)	5167 (36.2) c
Multiple surgical treatments *	2242 (15.71) c

Abbreviation: PD, Peyronie's disease.

^a Percentage referred to the total number of PD patients.

^b Percentage referred to PD patients undergoing intraplaque injections.

^c Percentage referred to PD patients undergoing surgery.

^*Simultaneously or in multiple stages.

Intraplaque injections showed a significant increasing trend over the years (p = 0.014). In contrast, grafting, penile plication, and penile prosthesis did not demonstrate a significant trend (p > 0.05), either increasing or decreasing, and remained stable over time (Figure 2).

FIGURE 2.

PD treatment trends in the United States from 2010 to 2022. PD, Peyronie's disease.

Penile implant surgery was conducted in 6909 (3.9%) PD patients. Inflatable prostheses constituted 96% of the devices implanted in this population. Grafting was described in 2319 men with PD, of whom 467 (20.14%) also underwent penile prosthesis implantation.

Mean age was significantly greater (p < 0.001) in patients who underwent only penile prosthesis implantation (61.71 ± 9.03 years) compared to men who underwent only plication (58.00 ± 10.81 years) or grafting (57.58 ± 9.06 years). Similarly, the mean time from diagnosis to treatment was significantly longer (p = 0.002) in subjects who underwent only penile implant surgery (444.71 ± 632.23 days) compared to individuals who underwent only plication (371.61 ± 556.12 days) or grafting (355.91 ± 452.73 days) techniques. No significant difference was found in CCI between the above‐mentioned groups (p = 0.087).

3.3. Predictors of de novo ED and surgical treatment after PD diagnosis

Within one year of being diagnosed with PD, 26,150 patients (14.78%) developed de novo ED, while 9493 men (5.36%) reported using PDE5I. Age, SDOH, and comorbidities such as obesity, smoking, diabetes, depression, and a history of penile trauma were associated with an increased risk of developing ED after a PD diagnosis. Surgical procedures like grafting (OR 2.054; 95% CI 1.845–2.285; p < 0.001) and plication (OR 1.854; 95% CI 1.735–1.980; p < 0.001) also raised the risk, with grafting showing the highest OR (Table 3). Similarly, CCI, obesity, smoking, diabetes, hypertension, depression, and penile trauma were significant predictors of requiring surgical intervention after a PD diagnosis. Intraplaque injections were also strongly associated with an increased need for surgery (OR 2.113; 95% CI 1.968–2.266, p < 0.001) (Table 4).

TABLE 3.

Multivariable logistic regression analysis for predictors of de novo erectile dysfunction (ED) after Peyronie's disease (PD) diagnosis.

Variable	Multivariable
	OR	95% CI	p‐value
Age	1.001	1.000–1.003	<0.001
CCI	0.924	0.917–0.930	0.016
SDOH	1.035	1.071–1.064	<0.001
Obesity	1.054	1.026–1.084	0.013
Smoking	1.029	1.022–1.056	<0.001
Diabetes	1.11	1.08–1.14	0.033
Hypertension	1.201	1.164–1.24	0.098
Depression	1.085	1.056–1.115	<0.001
Penile trauma	1.322	1.062–1.635	0.011
Grafting	2.054	1.845–2.285	<0.001
Plication	1.854	1.735–1.980	<0.001

Abbreviations: CCI, Charlson Comorbidity Index; CI, confidence interval; ED, erectile dysfunction; OR, odds ratio; PD, Peyronie's disease; SDOH, social determinants of health.

Statistically significant values are reported in bold.

TABLE 4.

Multivariable logistic regression analysis for predictors of surgical treatment in Peyronie's disease (PD) patients.

Variable	Multivariable
	OR	95% CI	p‐value
Age	0.997	0.994–0.996	<0.001
CCI	1.058	1.047–1.068	0.004
SDOH	0.998	0.951–1.05	0.974
Obesity	1.084	1.032–1.138	0.001
Smoking	1.161	1.108–1.217	<0.001
Diabetes	1.243	1.183–1.306	<0.001
Hypertension	1.194	1.124–1.27	<0.001
Depression	1.628	1.551–1.709	<0.001
Penile trauma	1.973	1.397–2.709	<0.001
Intraplaque injections	2.113	1.968–2.266	<0.001

Abbreviations: CCI, Charlson Comorbidity Index; CI, confidence interval; OR, odds ratio; PD, Peyronie's disease; SDOH, social determinants of health.

Statistically significant values are reported in bold.

4. DISCUSSION

Using a large nationwide database, we aimed to investigate the demographic information, clinical characteristics, and therapeutic approaches among patients with PD. First and foremost, when discussing the incidence of this condition, it is important to note that it can vary. Population‐based studies in the United States report an incidence ranging from 0.4% to 3.2%. ¹⁶ , ¹⁷ , ¹⁸ Notably, the Southern region, as observed by Moghalu, shows the highest frequency of diagnoses. ¹⁹ Lower rates have been documented in Asia, particularly in Japan, with an incidence of 0.6%, compared to higher rates reported in Italy (7.1%). ²⁰ , ²¹ Despite these geographic differences, it is widely accepted that the prevalence of PD increases with age. A large German survey involving 4432 participants found an incidence of 1.5% in men aged 30–39, rising to 6.5% in men over 70 years old. ¹⁶ In our analysis, the mean age of individuals with PD was 58.92 ± 11.19 years, consistent with other studies. ²² , ²³

Regarding risk factors, several have been demonstrated to be associated with the condition. The most frequently reported include age, diabetes, and smoking. ²⁴ , ²⁵ , ²⁶ Genetic predisposition, as well as penile trauma, also appear to play an important role. In the literature, Dupuytren's contracture has been reported in 20% of PD cases. ²⁷ This differs significantly from our findings, where, although present, it was diagnosed in only 3.10% of cases. Similarly, when considering the incidence of penile trauma, our data show a relatively low value (only 0.20% of PD patients had a diagnosed penile trauma). ²⁵ , ²⁸ However, we acknowledge that this finding needs to be contextualized, and its low rate could be due to underdiagnosis, particularly in cases involving microtrauma that do not prompt immediate medical consultation. Therefore, in studies based on diagnostic codes, such as ours, these cases may be missed. Further studies with more detailed clinical evaluations are necessary to explore this correlation.

PD and ED are closely interconnected, as the formation of fibrous plaques in PD leads to penile curvature, pain, and deformity, which can interfere with both erection and sexual intercourse. At the time of PD diagnosis, we found that ED was present in 28.23% of patients. More notably, when we examined the incidence of new ED diagnoses within one year following a PD diagnosis, the number of affected patients was 26,150 (14.78%). Our multivariate analysis indicates that the risk of developing de novo ED after a PD diagnosis is strongly associated with patient characteristics and comorbidities, such as age, SDOH, obesity, smoking, and diabetes, in addition to depressive disorders. The psychological impact of PD, including anxiety and emotional distress, can further aggravate sexual dysfunction. Although large database studies acknowledge these factors, they are rarely examined in detail. ¹⁹ , ²² , ²³ In our study, 18.97% of patients diagnosed with PD developed depression within the following year. The literature reports an even higher incidence of depressive symptoms, with rates reaching up to 80% in studies specifically focused on stress related to the condition. ²⁹ , ³⁰ A significant gap in the current body of research is the limited exploration of the effects of PD on interpersonal relationships, particularly from the partner's perspective. Smith et al. were among the first to suggest that a PD diagnosis may be a risk factor for relationship continuation. ³¹

The natural history of PD distinguishes between an acute phase and a chronic stabilization phase. The acute phase, generally defined as the period within 12 months from symptom onset, is characterized by active plaque formation, pain, and progressive penile curvature as scar tissue develops. In this stage, inflammation and fibrotic tissue remodeling play key roles. The chronic phase is marked by stabilization of the curvature, usually after a 6‐month period without further changes. Although pain tends to subside, the curvature and physical changes persist. Some degree of chronic inflammation may continue, contributing to lasting tissue effects. ³² , ³³ , ³⁴ For patients in the acute phase or those ineligible for surgery, non‐surgical treatments are available, aiming to reduce penile curvature, alleviate pain, and halt the progression of fibrosis. ⁶ Oral therapies are sometimes used especially in the early stages of the disease. PDE5Is, commonly used for ED, have shown promise in PD treatment by increasing cGMP levels, inhibiting collagen synthesis, and reducing fibrotic changes. ³⁵ Although commonly used, PDE5 inhibitors are not always considered a definitive treatment but are often regarded as a supportive therapy. In our study, 9493 patients initiated PDE5I therapy at diagnosis. Notably, only 32.7% of this group reported ED, suggesting that these drugs were often used to improve the condition and reduce the risk of permanent curvature. However, it is crucial to emphasize that many patients with PD may not require any form of treatment due to the moderate degree of their disease, which often results in minimal functional or psychological impairment. These cases highlight the importance of individualized patient assessment and a conservative management approach when appropriate. Among non‐surgical treatments, intralesional therapy has shown promise. Injectable treatments like CCH collagenase, calcium channel blockers (e.g., verapamil), and interferons have been explored, though often used off‐label. ³⁶ , ³⁷ , ³⁸ Collagenase, the only FDA‐approved treatment, has shown significant reductions in penile curvature and discomfort. ³⁹ Our database does not specify the specific agent used, so we refer to it generically as “injective” therapy. When we examined how many patients had undergone injections, we found that this number amounted to 12,755 patients, representing 7.21% of the total diagnoses of PD. Among these patients, 71.29% received this therapy as their sole treatment, while for the remaining 28.71%, this therapy represented an initial step, followed by surgical intervention. Indeed, once the deformity stabilizes and the pain subsides, surgical treatment becomes the gold standard for patients seeking definitive resolution of their condition. ⁴⁰ Multivariate analysis suggests that receiving intraplaque injections may increase the likelihood of requiring surgery in the future to definitively resolve the condition (OR = 2.113; 95% CI: 1.968–2.266, p < 0.001). The choice of surgery depends on the severity of the deformity, penile characteristics, and the presence of ED. ¹³ , ⁴¹ In our study, the most common procedure was penile plication, consistent with Walton et al.’s findings. ²² Plication, also known as corporoplasty, works by shortening the convex side of the penis to straighten it during erection and is recommended for patients with mild to moderate curvature and no ED. For more severe cases (>60–70°), grafting is often preferred, especially by men concerned about penile shortening, a natural outcome of plication. Our findings show a consistent distribution of these treatments over the years, with no clear evidence favoring one approach over another, although the decrease observed in 2022 is attributable to the fact that the collected data did not fully cover the entire year. When PD is associated with ED, penile prosthesis placement is considered the most effective surgical option. While grafting and plication correct the curvature and facilitate penetration, they do not address ED and can, in some cases, worsen erectile function. Our analysis found that both grafting and plication increase the risk of developing ED, with grafting showing the highest OR (OR = 2.054; CI = 1.845–2.285; p < 0.001), followed by plication (OR = 1.854; CI = 1.735–1.980; p < 0.001). In cases of mild curvature, a penile prosthesis alone may correct the deformity, but in more severe cases, additional straightening procedures may be necessary. ⁴² , ⁴³ Among patients who received a prosthesis, 90% opted for a three‐component inflatable device.

4.1. Strengths and limitations

To the best of our knowledge, this is the largest and most up‐to‐date real‐world data analysis of the demographic, clinical, and management aspects of patients with PD in the United States. It therefore provides a broad and, above all, realistic view of this condition, offering various insights to improve clinical practice and guide future research. However, several limitations should be considered to correctly interpret our findings. First, the retrospective nature of the data analysis prevents us from controlling for several confounding factors and is associated with numerous sources of bias, reducing the reliability of our results. Additionally, administrative databases such as PearlDiver do not provide access to granular clinical data (e.g., penile curvature, duration of the disease, surgical details, and postoperative complications), preventing several evaluations on PD from being carried out. In this regard, it is important to emphasize that the database does not include case‐specific clinical information. For instance, we are unable to determine the degree of penile curvature or the specific medications each patient received. However, this is beyond the scope of our intent, which is to provide a general understanding of the management of this condition. Furthermore, the accuracy of the diagnosis and treatment codes upon which our analysis is based depends on the precision of data entered by healthcare providers, making coding errors a potential issue. Moreover, this article focuses on insured patients, which limits the generalizability of our findings to individuals without insurance or with different types of coverage. Lastly, our study is restricted to patients who sought healthcare, potentially overlooking undiagnosed cases of PD and thus underestimating the true burden of the condition in the broader population.

5. CONCLUSIONS

This large‐scale, real‐world analysis of patients with PD provides valuable insights into the demographics, clinical characteristics, and treatment patterns in the United States. It confirms that comorbid conditions such as hypertension, diabetes, obesity, and smoking are highly prevalent among men with PD. It also shows that ED and depression are common issues in PD patients. In contrast, penile trauma is rare at the time of PD diagnosis. Despite the availability of multiple treatment options, less than 15% of men with PD undergo injective or surgical treatment. Intraplaque injections are the most common therapy administered after the diagnosis of PD, and their use has increased over the years. Surgical interventions, including penile plication, grafting, and prosthesis implantation, are performed in less than 10% of cases, often following initial non‐surgical treatment. Grafting is confirmed to be associated with a high risk of de novo ED, yet only approximately 20% of these procedures are accompanied by penile prosthesis implantation. Inflatable devices remain the preferred option for prosthetic surgery in patients with PD. These findings emphasize the need for personalized treatment approaches and further research to optimize therapeutic strategies for PD.

AUTHOR CONTRIBUTIONS

All authors reviewed and approved the final manuscript. Authors with the highest degree and contributions. Angelo Orsini: Conceptualization (Equal); data curation (equal); formal analysis (equal); methodology (equal); software (equal); writing—original draft (Lead), and writing—review & editing (equal). Eugenio Bologna: Formal analysis (supporting); investigation (supporting), and Software (Lead). Gabriele Bignante: Visualization (equal). Francesco Lasorsa: Visualization (equal). Luca Lambertini: Visualization (equal). Arianna Biasatti: Visualization (equal). Michele Marchioni: Supervision (supporting). Francesco Porpiglia: Supervision (supporting). Giuseppe Lucarelli: Supervision (supporting). Luigi Schips: Supervision (supporting). Davide Arcaniolo: Supervision (supporting). Marco De Sio: Supervision (supporting). Edward E. Cherullo: Supervision (supporting). Riccardo Autorino: (Corresponding Author); Supervision (equal) and Validation (equal). Celeste Manfredi: Supervision (equal); Validation (equal), and Visualization (equal).

CONFLICT OF INTEREST STATEMENT

The authors declare no conflict of interest.

Supporting information

TABLE S1 Codes used for PearlDiver Mariner database search.

Orsini A, Bologna E, Bignante G, et al. Peyronie's disease in the United States: A real‐world, 13‐year nationwide analysis of demographics, clinical characteristics, and treatment trends. Andrology. 2025;13:2265–2272. 10.1111/andr.70029

DATA AVAILABILITY STATEMENT

Raw data can be provided upon justified request to the corresponding author.