Peyroni’s disease maybe initial presentation of diabetes mel
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Peyronie’s disease (PD) is a superficial fibrosing disorder of the penis, resulting in plaque formation and penile deformity. PD usually has association with erectile dysfunction. Etiology of PD is multifactorial. Most common etiology is penile trauma, systemic causes are hypogonadism, diabetes, hypertension, and cardiovascular disease. According to few studies, smoking and alcohol consumption are important causes of PD.

A 30-year-old Indian man presented with complaint of pain in the penis during the act of coitus and also of slight bending of penis. He is barber by occupation and did not consume alcohol and tobacco. On examination, his vitals and systemic examination were within normal limit, and his body mass index (BMI) was 25.5. On local examination of penis (by goniometer), there was a slight bending of 20°. On further questioning, he also revealed that due to pain during the act of coitus, he developed loss of libido and unexplained weakness and increased sense of thirst.

On laboratory investigation, his CBC, LFT, and kidney function test (KFT) were normal. His serology for HIV, HbsAg, anti-HCV (hepatitis C virus), and veneral disease research laboratory test (VDRL) was negative. Dermatology opinion was taken to rule out sexually transmitted disease. He also did not have any pain in the lower back or pelvic area. His random blood sugar was 284?mg/dL, which was further confirmed by oral glucose tolerance test (OGTT) (fasting—146 mg/dL, at 2 h—248 mg/dL) and HbA1c—8.4%; serum testosterone level was 610 ng/mL.

There was no family history of diabetes mellitus (DM). A penile Doppler ultrasonography was done in full erection for evaluation of penile arterial and venous system, which showed few amorphous areas of ill-defined echogenicity within the substance of mid and lower segments of both corpora cavernosa, suggesting early fibrotic/calcified plaque formation along with few foci of calcification along the walls of left corpora cavernosa, which confirmed PD. On the basis of deranged blood sugar, he was diagnosed as a case of type 2 diabetes mellitus (T2DM); he was started on oral hypoglycemic agents (OHA) and his glycemic targets were achieved after 2 weeks. His symptoms of hyperglycemia also improved. Gradually during the period of 1 month, his complaint regarding pain during coitus and subjective feeling of slight bending of penis (10°) also improved.