031 Atypical Peyronies – A Common Clinical Population That Remains Unrecognized
Bibliographic record
Abstract
Peyronie's disease is a disorder of the tunica albuginea responsible for penile curvature, erectile dysfunction, pain, and impacts quality of life. Duplex ultrasonography is an adjunctive tool used in the work-up of Peyronie's disease able to measure vascular flow, cavernous smooth muscle content, calcification and/or plaque formation. While patients commonly manifest with palpable penile plaques in association with their curvature complaints, others are found to have occult septal abnormalities or punctate scarring. Our study aimed to characterize and further understand these patients and determine the clinical relevance of these ultrasound findings. Data from all men undergoing duplex ultrasonography at London Health Sciences Center for Peyronie's disease and/or erectile dysfunction over a three-year period were retrospectively reviewed. All patients were included who had first time ultrasound and complete available data. A total of 722 patients underwent evaluation with duplex ultrasound and composed our study cohort. Septal abnormalities were demonstrated in 217 (30%) patients, and punctate scarring in 197 (27%), with 72 (33%) and 148 (75%), respectively, having a normal physical exam. Predictive factors for septal abnormalities on multivariate analysis included history of trauma (OR 1.90, p = 0.04) and advanced age (OR 1.02, p = 0.01). Patients with septal scarring were more likely to have dorsal curvature (OR 3.81, p < 0.01). First-line treatment options for septal abnormalities associated with length loss, erectile dysfunction or curvature were intra-lesional verapamil (OR 2.53, p < 0.01) and PDE-5 inhibitors (OR 2.32, p < 0.01), with second line surgical reconstructive with plaque incision/excision (OR 2.96, p < 0.01). Punctate scars had conservative treatment as their preferred first-line treatment, with salvage therapy using penile prosthesis insertion for treatment refractory cases (OR 3.42 p<0.01).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".