To evaluate patient-reported temporal changes in penile curvature, pain, shortening, sexual function, and quality of life in men electing conservative treatment for PD.
Of 3,840 patients who underwent evaluation at our institution between 1990 and 2012, 719 were randomly selected to receive a mail-in questionnaire with topics including penile curvature, pain, shortening, sexual function, and quality of life. Men endorsing prior intralesional or surgical therapy were excluded.
125 patients completed the survey and met inclusion criteria. Median duration between onset of PD symptoms and survey completion was 8.4 years. Overall, 38% felt that their condition had overall improved and 26% their condition had worsened since onset. Penile curvature resolved in 43%, remained stable in 37%, and worsened in 20%. Twelve percent of men developed a second de-novo curvature. Penile pain occurred in 42%, among whom the pain persisted/worsened in 18% and completely resolved in 64%. Sixty-five percent reported penile shortening. Subjective erectile function decreased in 60%, and >40% experienced difficulties with penetrative intercourse. Sexual frequency decreased in 68% of patients and 59% reported decreased relationship satisfaction. Approximately 50% described negative psychological impacts on self-esteem and image.
The current report provides the most comprehensive and longest-term data on patient-reported outcomes in men electing non-surgical and non-injection therapies. Although approximately 40% of men reported overall and curvature improvement at a median 8.4-year follow-up, penile length loss, worsening sexual function, relationship dissatisfaction, and psychosocial distress occurred in the majority of PD men.
Urology. 2017 Nov 21 [Epub ahead of print]
Matthew Ziegelmann, Raevti Bole, Ross Avant, David Yang, Brian Montgomery, Landon Trost
Department of Urology, Mayo Clinic, Rochester, MN., Department of Urology, Mayo Clinic, Rochester, MN. Electronic address: .