The symptomatic burden of Peyronie's disease at presentation according to patient age: A critical analysis of the Peyronie's disease questionnaire (PDQ) domains

Abstract

Background Peyronie's disease (PD) has a huge impact on patients’ physical and psychological wellbeing. Objectives To investigate whether patients’ age has an impact on PD symptomatic burden at first presentation. Materials and methods Data from 129 consecutive heterosexual patients seeking first medical attention for PD at a single andrological tertiary‐referral centre were collected. All patients completed the International Index for Erectile Function (IIEF) and the PD questionnaire (PDQ). Descriptive statistics were used to compare clinical features between younger (≤40years) and older (>40 years) patients. Multivariable linear model assessed the impact of age, the degree of penile curvature and their impact on PDQ (total scores and its domains), after adjusting for PD duration and IIEF‐erectile function domain scores. Results Of 129, 24 (18.6%) patients were ≤40 years old. Young patients presented with a less severe curvature than older patients (median [interquartile ranges] 20° [15–36] vs. 50° [40–80]; p = 0.04). However, younger age was associated with higher psychological and physical symptoms, PDQ‐penile pain and PDQ‐symptom bother scores (Coeff −0.11, −0.21 and −0.17, respectively) (all p < 0.05). Moreover, the greater the degree of curvature, the higher the PDQ–psychological and physical symptoms and the PDQ‐symptom bother scores (Coeff. 0.21 and 0.22, respectively; all p < 0.05). Conclusion Around one in five men seeking first medical help for PD is younger than 40 years at presentation in the real‐life setting. PD‐related distress varies according to patients’ age, with younger men presenting with a greater risk of penile pain and symptom bother despite lower curvature.

What do patients with Peyronie's disease expect from therapy? A prospective multi‐center study

“…To the best of our knowledge, the present multi‐center study is the first to provide a prospective meticulous evaluation of patients’ pre‐treatment expectations of the conservative therapy and surgery in PD. The clinical features of our patient cohort corresponded to previous reports in PD, including patients’ age, comorbidities, plaque, and curvature characteristics as well as earlier treatment attempts 16–19 . We found that patients undergoing surgery had more positive and more negative expectations toward their treatment compared to their counterparts receiving conservative therapy.…”

“…22 Last but not the least, the higher degree of the penile curvature in patients undergoing surgery may also be a reason for more symptom bother, as other authors have previously demonstrated that the more pronounced the penile curvature, the higher the PDQ symptom bother as well as psychological and physical symptoms scores. 16,23 We found significant correlations between patients' negative expectations and symptom bother as well as psychological and physical symptoms, and a negative correlation between positive expectations and penile pain. Thus, these variables influence each other, and positive and negative treatment expectations may refer to diseaserelated symptoms.…”

“…In addition, more symptom bother as well as psychological and physical symptoms may be due to longer disease duration, different previous treatment attempts and patients’ varying ability or willingness to adapt to and accept the PD‐specific symptoms over time, as demonstrated in other chronic diseases, for example, chronic obstructive pulmonary disease or congestive heart failure 22 . Last but not the least, the higher degree of the penile curvature in patients undergoing surgery may also be a reason for more symptom bother, as other authors have previously demonstrated that the more pronounced the penile curvature, the higher the PDQ symptom bother as well as psychological and physical symptoms scores 16,23 . We found significant correlations between patients’ negative expectations and symptom bother as well as psychological and physical symptoms, and a negative correlation between positive expectations and penile pain.…”

“…The clinical features of our patient cohort corresponded to previous reports in PD, including patients' age, comorbidities, plaque, and curvature characteristics as well as earlier treatment attempts. [16][17][18][19] We found that patients undergoing surgery had more positive and more negative expectations toward their treatment compared to their counterparts receiving conservative therapy. In addition, surgery was an independent predictor of positive and negative pre-treatment expectations.…”

Ultrasound Elastography as a Diagnostic Tool for Peyronie’s Disease: A State-of-the-Art Review

“…Multiple studies have examined the occurrence of PD in young men, with reported prevalence rates ranging from 1.5% to 10.8% [ 13 , 14 , 15 , 16 ]. Some authors report an increase in the prevalence of PD in young people, noting that 18.6% of PD patients were ≤40 years old and 81.4% were >40 years old [ 17 ]. In our own study, we found similar results, with 16.9% of PD patients being ≤40 years old [ 18 ].…”