Penile curvature management in Italy: a survey analysis by the Italian Society of Urology

Authors

  • Andrea Mari Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally Invasive Urology and Andrology, Careggi Hospital, Florence
  • Simone Sforza Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally Invasive Urology and Andrology, Careggi Hospital, Florence
  • Andrea Cocci Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally Invasive Urology and Andrology, Careggi Hospital, Florence
  • Laia Bardina Galiana Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally Invasive Urology and Andrology, Careggi Hospital, Florence
  • Filippo Lipparini Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally Invasive Urology and Andrology, Careggi Hospital, Florence
  • Alessandro Antonelli Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona
  • Riccardo Bertolo Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona
  • Riccardo Campi Department of Experimental and Clinical Medicine, University of Florence, Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, Florence
  • Luca Cindolo Villa Stuart Private Hospital, Department of Urology, Rome
  • Giovanni Cochetti Department of General and Oncologic Surgery, St. Maria Hospital, University of Perugia
  • Fabrizio Dal Moro Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua
  • Cristian Fiori San Luigi Gonzaga Hospital, University of Turin, Department of Urology, Orbassano (TO)
  • Ugo Giovanni Falagario Department of Urology and Organ Transplantation, University of Foggia
  • Antonio Andrea Grosso Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally Invasive Urology and Andrology, Careggi Hospital, Florence
  • Bernardo Rocco IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome
  • Riccardo Schiavina Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna; Division of Urology, IRCCS Azienda Ospedaliero-Universitaria Bologna
  • Virginia Varca Urologic Unit, ASST Rhodense-Presidio di Garbagnate Milanese (MI)
  • Giorgio Ivan Russo Urology Section, Department of Surgery, University of Catania
  • Andrea Salonia Unit of Urology, Division of Experimental Oncology, Urological Research Institute (URI), IRCCS San Raffaele Scientific Institute, Milan
  • Vincenzo Ficarra Italian Society of Urology (SIU), Executive Committee Office, Rome
  • Vincenzo Mirone Italian Society of Urology (SIU), Executive Committee Office, Rome
  • Giuseppe Carrieri Department of Urology and Organ Transplantation, University of Foggia
  • Andrea Minervini Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally Invasive Urology and Andrology, Careggi Hospital, Florence

DOI:

https://doi.org/10.4081/aiua.2025.14205

Keywords:

La Peyronie's disease, Italian survey, survey, questionnaires, management, penile curvature

Abstract

Objective: To provide an updated national overview of the clinical management of congenital and acquired penile curvature (PC) in Italy, evaluating current diagnostic and therapeutic practices among Italian urologists.
Materials and methods: A 23-item anonymous digital survey was distributed by the Italian Society of Urology (SIU) to 2034 affiliated urologists between 2024 and 2025. The survey includes demographic data, diagnostic approaches, and treatment strategies for PC, including Peyronie’s disease (PD). Participants were categorized by practice setting and geographic region. SPSS software was used to conduct descriptive and comparative analyses.
Results: Overall, 442 urologists had completed the survey (response rate: 21.7%). Most participants were affiliated either with university hospitals (34.6%) or public non-university hospitals (32.8%). The major incidence of PD cases, as reported by 310 (70.1%) respondents, were in patients between 45-60 years old and the most frequent presentation was a dorsal curvature (223 responses, 50.5%). The routine clinical practice, as reported by respondents, includes anamnestic data with photographs collection and penile ultrasound (in 261 (59%) and 188 (42.5%) of respondents, respectively), while penile dynamic CCDU was mainly used in patients with erectile dysfunction. In regard to therapeutic strategies, 142 (32.8%) of urologists used Clostridium Collagenase Histolyticum (CCH) for intralesional therapy; a similar proportion used verapamil/nicardipine, despite limited supporting evidence. Interestingly, surgical approaches varied widely: tunica plication was preferred in non-complex cases by 169 (38.2%), while penile prosthesis was offered in complex cases by 129 (29.2%) urologists. Finally, penile prosthesis implantation was offered in patients with severe ED unresponsive to pharmacological therapy, regardless of penile curvature only by 176 respondents (39.8%), meanwhile, 177 respondents considered penile prothesis only for severe PC over >60 degrees associated with ED.
Conclusions: This nationwide survey reveals a significative heterogeneity in PC and PD management in Italy, with frequent reliance on off-label treatments and variable adherence to international guidelines. Economic limitations and regional differences appear to be a primary factor influencing clinical decisions and clinical practice. These findings underline the need for a major dissemination of evidence-based guidelines associated with national healthcare strategies aimed at standardized care and improving patient outcomes.

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Author Biographies

  • Andrea Salonia, Unit of Urology, Division of Experimental Oncology, Urological Research Institute (URI), IRCCS San Raffaele Scientific Institute, Milan

    Italian Society of Urology (SIU), Executive Committee Office, Rome, Italy

  • Vincenzo Ficarra, Italian Society of Urology (SIU), Executive Committee Office, Rome

    Department of Clinical and Experimental Medicine, University of Messina, Italy

  • Vincenzo Mirone, Italian Society of Urology (SIU), Executive Committee Office, Rome

    Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Italy

  • Giuseppe Carrieri, Department of Urology and Organ Transplantation, University of Foggia

    Italian Society of Urology (SIU), Executive Committee Office, Rome, Italy

  • Andrea Minervini, Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally Invasive Urology and Andrology, Careggi Hospital, Florence

    Italian Society of Urology (SIU), Executive Committee Office, Rome, Italy

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Published

02-12-2025

Issue

Vol. 97 No. 4 (2025)

Section

Original Papers - Andrology

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How to Cite

Penile curvature management in Italy: a survey analysis by the Italian Society of Urology. (2025). Archivio Italiano Di Urologia E Andrologia, 97(4). https://doi.org/10.4081/aiua.2025.14205