Peyronie%26apos;s Disease among Men Who Have Sex with Men: Characteristics, Treatment, and Psychosocial Factors

作者：Farrell Michael Ryan; Corder Christopher J; Levine Laurence A^*

来源：The Journal of Sexual Medicine, 2013, 10(8): 2077-2083.

DOI：10.1111/jsm.12202

• Peyronie%26apos
• s Disease
• Men Who Have Sex with Men
• Characteristics
• Treatment
• Psychosocial Factors
• Tunica Albuginea of the Corpora Cavernosa

Introduction. We describe the characteristics of Peyronie%26apos;s disease (PD) and its associated psychosocial implications in men who have sex with men (MSM). %26lt;br%26gt;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. %26lt;br%26gt;Main Outcome Measures. Subjective and objective presenting characteristics, MSM psychosocial factors. %26lt;br%26gt;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. %26lt;br%26gt;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 %26gt; 0.05). PD had a negative effect on emotional status (89.0% MSM, 80.5% non-MSM, P %26gt; 0.05) and intimate relationships (45.0% MSM, 64.0% non-MSM, P %26gt; 0.05). Nonsurgical treatment was given to 88.9% MSM and 76.5% non-MSM (P %26gt; 0.05), and corrective surgery in 29.6% MSM and 25.0% non-MSM (P %26gt; 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. %26lt;br%26gt;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.

• 出版日期2013-8