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Sexual Medicine Apr 2023Peyronie's disease has an impact on men's mental and physical health.
BACKGROUND
Peyronie's disease has an impact on men's mental and physical health.
AIM
We sought to translate the Peyronie's Disease Questionnaire into Danish, adapt it to the Danish cultural setting, and test it in a Danish population.
METHODS
Translation of the Peyronie's Disease Questionnaire was performed according to the guidelines for adapting health status measures for use in languages other than the source language by Beaton et al. The validated American Peyronie's Disease Questionnaire was developed to monitor patient symptoms after an intervention and to inspire a subsequent dialogue about physical and psychological symptoms with a healthcare provider, thereby allowing the patient and the healthcare professional to choose the best treatment. The expert committee agreed on a Danish version after cross-cultural adaptation. The Danish Peyronie's Disease Questionnaire was sent by electronic mail to a preselected group of 41 men with Peyronie's disease.
OUTCOMES
After completing the questionnaire, 32 men participated in a video interview regarding the questionnaire and were asked to identify any problematic fields or areas open to misunderstanding.
RESULTS
The Peyronie's Disease Questionnaire underwent major modifications in light of the comments of the first 10 respondents. Thereafter, only minor changes were made until data saturation was reached after 27 of the 32 respondents had been interviewed. In 87% of respondents Peyronie's disease bothered from the last time they had intercourse, and 93% of the men experienced being bothered by having intercourse less often. Peyronie's disease made 73% of respondents feel bodily discomfort, and 88% had intercourse less often than they used to have due to Peyronie's disease.
CLINICAL IMPLICATIONS
The Peyronie's Disease Questionnaire is a valuable tool in the crucial task of addressing Peyronie's disease, providing insight into the mental and sexual health problems as well as physical challenges faced by patients.
STRENGTHS AND LIMITATIONS
The interviewer's modest experience in conducting interviews is believed to have been duly compensated for by continuous and accumulating learning-while-doing process because the same interviewer conducted all of the interviews and did so consecutively.
CONCLUSIONS
Danish men expressed satisfaction with the questionnaire and found it valuable as a tool when visiting the doctor for the first time.
PubMed: 36970583
DOI: 10.1093/sexmed/qfac022 -
Archivio Italiano Di Urologia,... Mar 2023This study aims to investigate the relationship between Neutrophil- Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR) with Erectile Dysfunction (ED) and Peyronie's... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
This study aims to investigate the relationship between Neutrophil- Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR) with Erectile Dysfunction (ED) and Peyronie's disease (PD).
METHODS
We conducted a meta-analysis of the observational study by searching for the appropriate keywords in eight databases. The risk of publication bias of the included studies was assessed by Egger's test and Kendall's t. The data extraction was carried out for each study and analysed using Revman 5.0.
RESULTS
There were eleven eligible studies out of the 411 studies retrieved. Eight studies were conducted on cases of erectile dysfunction, and three studies on Peyronie's disease. There was a significant relationship between NLR, PLR and ED (SMD: 0.59, 95% CI: 0.33-0.85 and SMD: 0.64, 95% CI: 0.13-1.16, respectively). The same was also found for PD. The active phase of PD tended to have higher NLR (SMD: 0.68, 95% CI: 0.43-0.92) and PLR (SMD: 0.27, 95% CI: 0.06-0.49) compared to the chronic phase. No publication bias was found in both ED and PD studies.
CONCLUSIONS
NLR and PLR indicate an ongoing inflammatory process in both ED and PD. These findings can be used as markers of treatment and prognosis of both diseases in sexual health care.
Topics: Male; Humans; Erectile Dysfunction; Neutrophils; Penile Induration; Lymphocytes; Blood Platelets
PubMed: 36924369
DOI: 10.4081/aiua.2023.11162 -
Archivio Italiano Di Urologia,... Mar 2023To investigate a possible relationship between a history of congenital penile curvature (CPC) and Peyronie's disease (PD), and to characterize the psychological profile...
OBJECTIVE
To investigate a possible relationship between a history of congenital penile curvature (CPC) and Peyronie's disease (PD), and to characterize the psychological profile of patients suffering from PD, with or without concomitant CPC.
METHODS
We included 519 patients with Peyronie's disease (PD), of which 73 were found to have underlaying CPC. As a comparator population, we selected 2166 patients without PD, referring to our tertiary care clinic. In this population we detected 15 subjects with CPC. All patients completed the GAD-7 (Generalized-Anxiety-Disorder - 7 questions) and the PHQ-9 (Patient-Health-Questionnaire - 9 questions) questionnaires.
RESULTS
The overall prevalence of CPC in PD-patients was 14.07%, compared to a prevalence of 0.69% in the non-PD control population (p < 0.00001). Moderate-to-severe anxiety was found to be present in 89.4% of all PD-patients. Significantly higher proportions of patients with CPC associated with PD showed severe anxiety, compared to patients with PD alone (57.5% vs. 36.7%, respectively, p = 0.0008). Moderate- severe depression was found to be present in 57.8% of all PD- patients. Significantly higher proportions of PD patients with a history of CPC showed severe depression, compared to patients with PD alone (13.6% vs. 3.36%, respectively, p < 0.0002). GAD-7 median scores were significantly higher in patients with more severe penile curvatures (> 45°; p = 0.029). We did not detect a statistically significant difference between PHQ-9 medi- an scores based on the severity of PD (p = 0.53). Analysis of PHQ-9 and GAD-7 median scores showed significantly worse depressive and anxious symptoms in younger patients (p < 0.001 and p = 0.0013, respectively).
CONCLUSIONS
The presence of congenital-penile-curvature may represent a risk factor for the subsequent onset of Peyronie's disease. Moderate/severe anxiety and moderate/severe depression were reported in a high fraction of cases. Anxiety was significantly higher in patients with more severe penile-curvatures, and depression was present independently of the degree of penile curvature. Depression and anxiety were found to be more severe in younger subjects.
Topics: Male; Humans; Penile Induration; Penis; Surveys and Questionnaires; Treatment Outcome
PubMed: 36924365
DOI: 10.4081/aiua.2023.11238 -
Gels (Basel, Switzerland) Feb 2023Hyaluronic acid (HA) is a glycosaminoglycan widely utilised in different fields of medicine. We aimed to provide a comprehensive overview of the scientific evidence on... (Review)
Review
Hyaluronic acid (HA) is a glycosaminoglycan widely utilised in different fields of medicine. We aimed to provide a comprehensive overview of the scientific evidence on the use of HA in andrology. A review of the literature to identify pertinent studies concerning the use of HA in andrology was carried out on the Medline, EMBASE, and the Cochrane databases, with no time restriction up to December 2022. Penile girth enlargement (PGE) using HA proved to be safe and effective in enhancing the diameter of the penis, with durable and satisfactory outcomes in long-term follow-up. Injection of HA in the glans seems to represent an alternative treatment option for those patients with premature ejaculation (PE) who fail to respond to conventional medications. HA intra-plaque injections represent a valid option which may contribute to restore sexual activity in patients with Peyronie's disease (PD). The adoption of HA filler injections should always be tailored to the patient's peculiar anatomy and underlying condition. More robust evidence is required to achieve a uniformed consensus regarding the use of HA in andrology, and further efforts should continue to improve the current injection techniques and HA products.
PubMed: 36826290
DOI: 10.3390/gels9020118 -
Indian Journal of Urology : IJU :... 2023The field of genitourinary prosthetics has evolved rapidly to become the standard of care for conditions such as incontinence and refractory erectile dysfunction. Its... (Review)
Review
The field of genitourinary prosthetics has evolved rapidly to become the standard of care for conditions such as incontinence and refractory erectile dysfunction. Its scope has expanded to encompass newer indications such as Peyronie's disease and gender-affirming surgeries. This review, based on the Urological Society of India's Best Essay Award 2022, aims to elaborate on the advances in the field of urological prosthetics in the past 20 years as well as to provide an insight into ongoing research and what one can expect to see in the next decade, particularly in the area of penile and testicular prosthetics as well as treatment of incontinence. A PubMed and patent search was performed to achieve these objectives. Future considerations include improving acceptance, reliability, making them more accessible for developing countries and improving training and education to improve outcomes.
PubMed: 36824106
DOI: 10.4103/iju.iju_90_22 -
Journal of Biological Physics Jun 2023Calcium ([Formula: see text]), inositol trisphosphate ([Formula: see text]), and nitric oxide (NO) signaling are essential to maintain the structural integrity and...
Calcium ([Formula: see text]), inositol trisphosphate ([Formula: see text]), and nitric oxide (NO) signaling are essential to maintain the structural integrity and physiological activity of fibroblast cells. The accumulation of excess quantity of NO for longer periods can lead to a variety of fibrotic disorders, including heart disease, penile fibrosis in Peyronie's disease (PD), and cystic fibrosis. The dynamics of these three signaling processes and their interdependence in fibroblast cells are not clearly known to date. A systems biology model is proposed using reaction-diffusion equations for calcium, [Formula: see text], and calcium-dependent NO synthesis in fibroblast cells. The finite element method (FEM) is used to examine [Formula: see text], [Formula: see text], and NO regulation and dysregulation in cells. The results throw light on the conditions that disturb the coupled [Formula: see text] and [Formula: see text] dynamics and the influence of these factors on the levels of NO concentration in the fibroblast cell. The findings suggest that changes in source inflow, buffers, and diffusion coefficient might induce an increase or reduction in nitric oxide and [Formula: see text] synthesis, resulting in fibroblast cell diseases. Furthermore, the findings provide new information regarding the size and intensity of diseases in response to changes in several factors of their dynamics, which has been linked to the development of cystic fibrosis and cancer. This knowledge could be valuable for developing novel approaches to the diagnosis of diseases and therapies for various disorders of fibroblast cells.
Topics: Male; Humans; Nitric Oxide; Cystic Fibrosis; Calcium; Signal Transduction; Fibrosis
PubMed: 36811722
DOI: 10.1007/s10867-022-09624-w -
Australian Journal of General Practice 2023Male sexual dysfunction (MSD) can affect males of all ages. The most common problems associated with sexual dysfunction include low sexual desire, erectile dysfunction,... (Review)
Review
BACKGROUND
Male sexual dysfunction (MSD) can affect males of all ages. The most common problems associated with sexual dysfunction include low sexual desire, erectile dysfunction, Peyronie's disease and disorders of ejaculation and orgasm. Each of these male sexual problems can be difficult to treat, and some males may have more than one form of sexual dysfunction.
OBJECTIVE
This review article provides an overview of the clinical assessment and evidence-based management strategies for MSD problems. Emphasis is placed on a practical set of recommendations relevant to general practice.
DISCUSSION
Comprehensive clinical history-taking, tailored physical examination and relevant laboratory testing can provide relevant clues for MSD diagnosis. Modifying lifestyle behaviours, managing reversible risk factors and optimising existing medical conditions are important first-line management options. Medical therapy can be initiated by general practitioners (GPs) with subsequent referrals to a relevant non-GP specialist(s) if patients do not respond and/or require surgical interventions.
Topics: Humans; Male; Erectile Dysfunction; Sexual Dysfunction, Physiological; Ejaculation; Penile Induration; Physical Examination
PubMed: 36796767
DOI: 10.31128/AJGP-09-22-6559 -
International Braz J Urol : Official... 2023To provide an overview of low-intensity extracorporeal shockwave therapy (LIEST) for erectile dysfunction (ED), pointing out which concepts are already consolidated and... (Review)
Review
OBJECTIVES
To provide an overview of low-intensity extracorporeal shockwave therapy (LIEST) for erectile dysfunction (ED), pointing out which concepts are already consolidated and which paths we still need to advance.
MATERIALS AND METHODS
We performed a narrative review of the literature on the role of shockwave therapies in erectile dysfunction, selecting publications in PUBMED, including only relevant clinical trials, systematic reviews and meta-analyses.
RESULTS
We found 11 studies (7 clinical trials, 3 systematic review and 1 meta-analysis) that evaluated the use of LIEST for the treatment of erectile dysfunction. One clinical trial evaluated the applicability in Peyronie's Disease and one other clinical trial evaluated the applicability after radical prostatectomy.
CONCLUSIONS
The literature presents little scientific evidence but suggests good results with the use of LIEST for ED. Despite a real optimism since it is a treatment modality capable of acting on the pathophysiology of ED, we must remain cautious, until a larger volume of higher quality studies allows us to establish which patient profile, type of energy and application protocol will achieve clinically satisfactory results.
Topics: Humans; Male; Erectile Dysfunction; Extracorporeal Shockwave Therapy; Penile Induration; Prostate; Prostatectomy; Treatment Outcome
PubMed: 36794846
DOI: 10.1590/S1677-5538.IBJU.2023.9904 -
International Journal of Impotence... May 2024Peyronie's disease (PD) is a debilitating pathology which is associated with penile curvature and erectile dysfunction due to the formation of fibrotic plaques in the...
Peyronie's disease (PD) is a debilitating pathology which is associated with penile curvature and erectile dysfunction due to the formation of fibrotic plaques in the penile tunica albuginea. In the present study, we developed a novel rabbit model of PD via subtunical injection of recombinant transforming growth factor (TGF)-β1 protein and characterized erectile function and histopathological endpoints following plaque formation. Ten adult male, New Zealand white rabbits were randomized into 3 experimental groups including nonsurgical controls (NSC, N = 3) and those receiving subtunical injections of vehicle (N = 3) or TGF-β1 protein (0.5 µg/50 µl; N = 4). Following 1 month post-op, focal fibrous plaques composed of disorganized collagen type I and III bundles as well as fragmented elastin fibers at TGF-β1 injection sites were observed in contrast to control groups. Cavernosometric and cavernosographic evaluations revealed no significant differences in maximum intracorporal pressures or substantial curvature during papaverine-induced erection in either the vehicle or TGF-β1 cohorts. Immunohistochemical and histomorphometric analyses demonstrated significant increases in elastase 2B expression in TGF-β1-induced plaques as well as significant declines in matrix metalloproteinase (MMP)-2 and -9 expression relative to control levels. Our results demonstrate that PD-like fibrotic plaques can be created in the rabbit penile tunica albuginea following TGF-β1 injection.
PubMed: 36782023
DOI: 10.1038/s41443-023-00671-y