Peyronie disease (PD) is characterized by penile plaques, penile curvature, and pain. These symptoms occur due to focal fibrosis of the tunica albuginea. The underlying cause of PD is still unknown but numerous epidemiological studies demonstrate that its prevalence may reach up to 10% among adult men. PD does not only affect the penis itself as it may also impact patients' psychological health, relationships with their sexual partners, and emotional well-being.
A significant amount of PD patients also report erectile dysfunction (ED) and the exact mechanisms involved in this phenomenon are not clear. In this post hoc analysis, we evaluated the impact of PD symptoms (i.e. penile curvature, penile shape, penile rigidity, pain, plaques) on PD-related bother and erectile function in patients with PD.
We have evaluated the data from IMPRESS-1 and IMPRESS-II phase 3 clinical trials which included 832 PD patients. Analyzing the clinical characteristics and symptoms of these patients revealed that pain during intercourse and PD bother had a significant impact on erectile function whereas erectile function did not appear to be directly influenced by the presence of plaques, penile curvature deformity, or penile shortening. This finding is of interest because it has been previously hypothesized that ED occurs because of the alterations in penile morphology and hemodynamics among patients with PD. Moreover, penile pain was found to be the most bothersome symptom of PD in our, followed by changes in penile shape.
Our post hoc analysis offers unique insight into the potential psychosexual impact of baseline characteristics on PD-related bother and erectile function. Clinicians who are treating PD patients may consider the impact of PD on psychosocial well-being and provide emotional support to their patients during the treatment course.
Written by: Ege Can Serefoglu, MD, FECSM, Associate Professor of Urology, Editor in Chief, International Journal of Impotence Research, Istanbul, Turkey.
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