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Peyronie's Disease among Men Who Have Sex with Men: Characteristics,Treatment, and Psychosocial Factors
Authors:Michael Ryan Farrell  Christopher J Corder  Laurence A Levine
Institution:1. Department of Urology, Rush University Medical Center, Chicago, IL, USA;2. Department of Urology, University of Nebraska Medical Center, Omaha, NE, USA
Abstract:IntroductionWe describe the characteristics of Peyronie's disease (PD) and its associated psychosocial implications in men who have sex with men (MSM).AimThe 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 MeasuresSubjective and objective presenting characteristics, MSM psychosocial factors.MethodsWe 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.ResultsA 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.ConclusionsFew 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. Farrell MR, Corder CJ, and Levine LA. Peyronie's disease among men who have sex with men: Characteristics, treatment, and psychosocial factors. J Sex Med 2013;10:2077–2083.
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