Predicting Delay in Presentation in Men with Peyronie's Disease
ABSTRACT Many men with Peyronie's disease (PD) delay presentation to a urologist. The reasons for this are unclear.
To define the differences in men who present early compared to those presenting in a delayed fashion and to determine predictors of delayed presentation.
A retrospective analysis of all patients presenting for the first medical evaluation of PD. All patients underwent a standard history and physical examination and had a standardized deformity assessment. Demographic and PD parameters were recorded.
Statistical comparison was used to define factors that were different between early and delayed presenters and multivariable analysis was used to define predictors of presentation >12 months.
482 patients were analyzed, 61% presenting ≤12 months, 39% >12 months. Mean patient age was 52 ± 13 years and mean duration of PD was 17 ± 30 months. Mean measured curvature was 42° ± 19°. Multivariable analysis revealed that delayed presentation patients were significantly more likely to be older (odds ratio [OR] = 4.0), to be in long-term relationships (OR = 3.6), to have dorsal curvature (OR = 2.5), to have curvature <45° (OR = 3.3), to be heterosexual (OR = 2.0), and to have simple deformity (OR = 1.5).
One-third of men with PD presented in a delayed fashion and they tended to be older, to be in long-term relationships, to have dorsal curvature, or to have simple deformity.
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ABSTRACT: Objective Male genital image has a significant impact on sexual functioning and quality of life. This concept will be defined, and attempts to operationalize and measure it will be critiqued. Selected medical conditions and surgical treatments that impact male genital image will be highlighted, and discussed. Method A PubMed review of genital image measurement was performed, along with a review of selected medical conditions and surgeries that affect the appearance and functioning of the male genitals including micro-penis, hypospadias, Peyronie's disease, and genital cancers. Results Male genital image does appear to be a measurable attribute, and is correlated with a number of sexual health outcomes. Present measurement methods, however, may only apply to healthy populations. Furthermore, medical conditions affecting the appearance and functioning of the genitals appear to have significant impact on genital image as well as on quality of life. Discussion Male genital image should be taken into account when considering medical interventions affecting the genitalia. Better measures of genital image need to be developed and validated; this will allow for better understanding of the psychosexual outcomes of genital image, as well as for examining how genital image can be improved.Sexologies 04/2012; 21(2):43–47. DOI:10.1016/j.sexol.2011.11.001
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ABSTRACT: Introduction. Peyronie's disease (PD) is characterized by an accumulation of scar tissue in the tunica albuginea of the penis that causes curvature and deformity. PD can result in psychological distress, depression, or anxiety, which often goes untreated. Aims. To review the current literature on the psychological impact of PD, educate healthcare providers about the psychological components of the disease, and propose interventions that address the psychological and sexual challenges patients and their partners may encounter. Methods. We performed a MEDLINE search, limited to English, using the terms "Peyronie's disease" AND "psychological" OR "psychosocial," and select references were included for review. Main Outcome Measure. Critical review of the currently available English language literature. Results. PD and its associated deformity often impairs sexual relations and frequently leads to psychological and psychosocial sequelae for affected individuals. Many men experience depression, low self-esteem, and emotional distress; these problems markedly diminish the quality of life for affected individuals. The literature suggests that as many as 81% of men report "emotional difficulties," 48% report clinically meaningful depression (26% moderate; 21% severe), and 54% report relationship problems due to PD. The challenges imposed by PD include alterations in sexual relationships, restrictions on intimacy, social isolation, and stigmatization, all of which are linked and reinforce each other. Physicians may be unaware of the psychological sequelae suffered by patients and their partners. Conclusions. Improved awareness and education about the psychological consequences and treatment options for PD are necessary among healthcare providers. To best help patients and optimize outcomes, a team-based approach is needed that includes psychosocial assessment and appropriate resource referrals for the patient and his sexual partner. Nelson CJ and Mulhall JP. Psychological impact of Peyronie's disease: A review. J Sex Med **;**:**-**.Journal of Sexual Medicine 11/2012; 10(3). DOI:10.1111/j.1743-6109.2012.02999.x · 3.15 Impact Factor
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ABSTRACT: Objectif L’image sexuelle masculine a un impact important sur la qualité de vie et le fonctionnement sexuel. Dans cet article, une définition du concept et des tentatives pour l’opérationnaliser et l’évaluer seront présentées de façon critique. Des affections médicales et traitements chirurgicaux qui ont un impact sur l’image génitale masculine seront ciblés et discutés. Méthode Une recherche portant sur les mesures de l’image du sexe masculin a été réalisée sur PubMed, cela aussi bien sur des affections médicales ciblées que des approches chirurgicales qui affectent l’apparence et le fonctionnement des organes génitaux masculins, comme le micropénis, l’hypospadias, la maladie de La Peyronie et les cancers génitaux. Résultats L’image du sexe masculin semble être un attribut mesurable et corrélé à un certain nombre de données en matière de santé sexuelle. Toutefois, que les méthodes de mesure actuelles pourraient ne s’appliquent qu’aux populations en bonne santé. En outre, les conditions médicales affectant l’aspect et le fonctionnement des organes génitaux semblent avoir un impact important sur l’image génitale aussi bien que sur la qualité de vie. Discussion L’image sexuelle masculine devrait être prise en compte lors d’interventions médicales touchant les organes génitaux. De meilleurs instruments de mesure de l’image génitale devraient être mis au point et validés, ce qui permettrait d’en mieux comprendre les effets psychosexuels et d’étudier comment l’améliorer.Sexologies 04/2012; 21(2):71–76. DOI:10.1016/j.sexol.2011.11.002