Peyronie's disease among men who have sex with men: characteristics, treatment, and psychosocial factors
- PMID: 23679656
- DOI: 10.1111/jsm.12202
Peyronie's disease among men who have sex with men: characteristics, treatment, and psychosocial factors
Abstract
Introduction: We describe the characteristics of Peyronie's disease (PD) and its associated psychosocial implications in men who have sex with men (MSM).
Aim: The aims of this article are to identify presenting characteristics and treatment for MSM with PD, compare these findings to non-MSM PD patients, and determine the psychosocial impact of PD among MSM.
Main outcome measures: Subjective and objective presenting characteristics, MSM psychosocial factors.
Methods: We identified 27 MSM with PD presenting from 2000 to 2012 through a retrospective chart review. A random selection of 200 non-MSM PD patients was identified, who presented during the same time period. A prospective nonvalidated questionnaire was given to MSM PD patients for evaluation of psychosocial constructs.
Results: A traumatic event leading to activation of PD was identified equally among MSM and non-MSM (P = 0.815). Most common recognized activators of PD among MSM were: penetrative sexual intercourse (22.2%), self-stimulation (11.1%). More MSM presented with the primary complaint of penile deformity, including narrowing, indentation, hourglass, and hinge (11.1% MSM vs. 1.0% non-MSM, P = 0.01). No differences in total curvature, erection grade were found (P > 0.05). PD had a negative effect on emotional status (89.0% MSM, 80.5% non-MSM, P > 0.05) and intimate relationships (45.0% MSM, 64.0% non-MSM, P > 0.05). Nonsurgical treatment was given to 88.9% MSM and 76.5% non-MSM (P > 0.05), and corrective surgery in 29.6% MSM and 25.0% non-MSM (P > 0.05). Of the 75.0% of MSM engaging in anal sex, 41.7% reported penetrative anal intercourse as the activator of PD. Among MSM, 31.3% experienced decreased libido, 50.0% decreased frequency of sexual activity, 92.9% were self-conscious about the appearance of their penis, and 92.9% were dissatisfied with the size of their penis.
Conclusions: Few differences exist in the clinical presentation and treatments used between MSM and non-MSM PD patients. There was evidence of emotional distress in both groups. As a result, psychosexual assessment and treatment, when indicated, should be considered essential to the patient presenting with PD.
Keywords: Characteristics; Men Who Have Sex with Men; Peyronie's Disease; Psychosocial Factors; Treatment; Tunica Albuginea of the Corpora Cavernosa.
© 2013 International Society for Sexual Medicine.
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