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Moncada I, Krishnappa P, Zaccaro C, Fraile A, Romero-Otero J, Martinez-Salamanca JI, Lledó-Garcia E. Penile prosthesis implantation is safe and effective in Peyronie's disease patients with and without erectile dysfunction. Int J Impot Res 2024:10.1038/s41443-024-00938-y. [PMID: 38909107 DOI: 10.1038/s41443-024-00938-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 06/07/2024] [Accepted: 06/13/2024] [Indexed: 06/24/2024]
Abstract
Penile prosthesis (PP) is the mainstay of treatment in Peyronie's disease (PD) with co-existent refractory erectile dysfunction (ED). This study aimed to assess the clinical outcomes of patients who underwent PP as the first-line surgical treatment in PD without ED. A total of 636 patients underwent PP for PD from 2012 to 2022, but only 168 patients who underwent PP as first-line surgical management for PD with or without ED were included in the study. The mean (SD) age of 168 patients was 56.3 years (12.4). The mean curvature of the "PD with ED" group and the "PD without ED" group were 38.2 (5.6) degrees and 42.2 (5.9) degrees. The median (IQR) follow-up was 56.0 months (34.5- 61.4). Most (86.9%) patients underwent 3-piece inflatable PP. An important finding is that 33 patients (19.6%) without ED had undergone PP. Mechanical failure requiring revision surgery was less common in the 'without ED' group than in the ED group (6.8% vs. 10.2%, p 0.04). Most PD patients without ED (87.9%, 29/33) and with ED (88.9%, 120/135) were "satisfied" after PP implantation at six months, as defined by a score of ≥4 on a 5-point Likert scale. If surgery is offered in PD, PP may be considered a safe and effective first-line surgical treatment regardless of the ED, given the acceptable complications and high satisfaction rates. However, this new concept warrants further research.
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Affiliation(s)
- Ignacio Moncada
- Department of Urology and Robotic Surgery, Hospital Universitario Sanitas la Zarzuela, 28023, Madrid, Spain
| | - Pramod Krishnappa
- Department of Urology and Robotic Surgery, Hospital Universitario Sanitas la Zarzuela, 28023, Madrid, Spain.
- Andrology Division, Department of Urology, AndroNeo, Orchidz Health, NU Hospitals, Bangalore, 560010, India.
| | - Claudia Zaccaro
- Department of Urology and Robotic Surgery, Hospital Universitario Sanitas la Zarzuela, 28023, Madrid, Spain
| | - Augustin Fraile
- Department of Urology, Hospital Universitario Ramon y Cajal, 28034, Madrid, Spain
| | | | - Juan Ignacio Martinez-Salamanca
- Lyx Institute of Urology, Universidad Francisco de Victoria, Hospital Universitario Puerta De Hierro-Majadahonda, 28222, Madrid, Spain
| | - Enrique Lledó-Garcia
- Department of Urology, Hospital General Universitario Gregorio Marañón, 28007, Madrid, Spain
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2
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Gundogdu G, Nguyen T, Namasivayam A, Starek S, Gelman J, Mauney JR. Characterization of a novel rabbit model of Peyronie's disease. Int J Impot Res 2024; 36:269-274. [PMID: 36782023 PMCID: PMC11035118 DOI: 10.1038/s41443-023-00671-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/25/2023] [Accepted: 01/30/2023] [Indexed: 02/15/2023]
Abstract
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.
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Affiliation(s)
- Gokhan Gundogdu
- Department of Urology, University of California, Irvine, Orange, CA, USA
| | - Travis Nguyen
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Aarthi Namasivayam
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Stephanie Starek
- Department of Urology, University of California, Irvine, Orange, CA, USA
| | - Joel Gelman
- Department of Urology, University of California, Irvine, Orange, CA, USA
| | - Joshua R Mauney
- Department of Urology, University of California, Irvine, Orange, CA, USA.
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA.
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Kraglund R, Durukan E, Giraldi A, Fode M. The association between Peyronie's disease and depression: a scoping review. Sex Med Rev 2024; 12:221-229. [PMID: 37902293 DOI: 10.1093/sxmrev/qead045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 10/31/2023]
Abstract
INTRODUCTION Peyronie's disease (PD) can have an immense psychological impact, with depression being a reported possible, severe consequence. To date, no literature reviews have systematically and critically assessed the relationship between PD and depression. OBJECTIVES The study sought to identify and critically appraise the current literature on the association between PD and depression. METHODS Studies had to address men with PD or probable PD and assess depression or depressive symptoms. Quantitative and qualitative, peer-reviewed, primary, empirical studies written in English or Danish were included. According to the guidelines for scoping reviews and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews) guideline, we performed a systematic review of PubMed, PsycINFO, Embase, CINAHL, the Cochrane Library, and Web of Science. Reference lists of included studies were screened for additional sources. Gray literature was searched for in Google Scholar and Bielefeld Academic Search Engine. Data were charted using a data extraction form, and critical appraisal was performed using the QuADS (quality assessment with diverse studies) tool. RESULTS Thirteen studies were included. Most studies had a cross-sectional design, and also cohort studies and longitudinal observational studies without a control group were found. Depression was assessed mainly by validated questionnaires or diagnostic codes. Questionnaire studies found a prevalences of moderate to severe depression of 24% to 48%, while studies using diagnostic codes found depression in 4% to 37% of men with PD. The quality of the included studies varied from 38% to 82% of the maximum possible score in the QuADS assessment. CONCLUSION While most studies describe an association between PD and depression, the evidence is not comprehensive. The current literature is especially at risk of selection bias and the influence of confounding factors, and a direct causality between PD and depression cannot be established. Future research calls for more methodically rigorous studies as well as qualitative studies to understand the relationship.
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Affiliation(s)
- Rune Kraglund
- Department of Urology, Copenhagen University Hospital-Herlev and Gentofte Hospital, Herlev 2730, Denmark
- Sexological Clinic, Mental Health Center, Copenhagen University Hospital-Mental Health Services CPH, Copenhagen 2100, Denmark
| | - Emil Durukan
- Department of Urology, Copenhagen University Hospital-Herlev and Gentofte Hospital, Herlev 2730, Denmark
| | - Annamaria Giraldi
- Sexological Clinic, Mental Health Center, Copenhagen University Hospital-Mental Health Services CPH, Copenhagen 2100, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen 2200, Denmark
| | - Mikkel Fode
- Department of Urology, Copenhagen University Hospital-Herlev and Gentofte Hospital, Herlev 2730, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen 2200, Denmark
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Tahmasbi F, Soleimanzadeh F, ZehiSaadat M, Lotfi B, Moghadam SS. Chronological perspective of substitute materials used for the surgical treatment of Peyronie’s disease: A scoping review of literature. Urologia 2022:3915603221137947. [DOI: 10.1177/03915603221137947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This comprehensive scoping review aimed to identify all up-to-date original publications relating to substitute materials used for the surgical treatment of Peyronie’s disease (PD), and characterize what material in which chronological trends were published in the current literature. Using the PCC framework (P: population, C: concept, and C: context), a search strategy was developed and used in four electronic databases, in addition to the Google scholar. All current published, in-press, and pre-print manuscripts with available English full-text were included. Eligible studies were required to be original research articles of any study design, reporting the usage of grafts on surgical treatment of PD. Included studies were reported in a narrative synthesis format. A total of 3379 articles were identified via an electronic search of databases and a total of 171 articles entered this scoping review. Most studies originated from Europe ( n = 72) and North America ( n = 66). Reports from the other continents increase in number in the 21st century. Highest number of the published papers was seen in 2001 to 2005 pentad. Autologous grafts (53.5%). Allografts (22.7%) and xenografts (15.7%) were the most frequently reported materials. Time flow of the used material and the alterations in trends for them is quite considerable. A global perspective of relevant publications on substitute materials in the surgical management of PD is presented in this review. The information in this summary may assist in establishing future research priorities in this area.
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Affiliation(s)
- Fateme Tahmasbi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farzin Soleimanzadeh
- Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Urology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahsa ZehiSaadat
- Department of Urology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behzad Lotfi
- Department of Urology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Parikh NN, Heslop DL, Bajic P, Bole R, Farrell MR, Levine LA, Ziegelmann MJ. A Review of Treatment-Related Outcomes in Female Partners of Men With Peyronie's Disease—An Opportunity for Improved Assessment. Sex Med Rev 2020; 8:548-560. [DOI: 10.1016/j.sxmr.2020.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/18/2020] [Accepted: 04/28/2020] [Indexed: 12/22/2022]
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About the drawback of collagenase. Int J Impot Res 2020; 33:570-571. [PMID: 32317742 DOI: 10.1038/s41443-020-0286-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/22/2020] [Accepted: 04/09/2020] [Indexed: 01/19/2023]
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Randhawa K, Shukla CJ. Non-invasive treatment in the management of Peyronie's disease. Ther Adv Urol 2019; 11:1756287218823671. [PMID: 30792820 PMCID: PMC6376494 DOI: 10.1177/1756287218823671] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 12/05/2018] [Indexed: 12/16/2022] Open
Abstract
Peyronies disease (PD) is estimated to affect approximately 3-9% of men worldwide and maybe associated with pain, erectile dysfunction and penile deformity including shortening. The condition has significant debilitating effects on quality of life, self-esteem and psychological wellbeing in addition to sexual function. Surgical results add further to this by patients having dissatisfaction with various aspects of outcomes. Non-surgical management may allow patients to avoid the morbidities associated with surgery and still achieve improved functional and aesthetic outcomes. Several non-surgical options are currently being employed in the treatment of PD that may reduce or stabilize both objective measures (e.g. penile length and deformity) and subjective measures (including sexual function, pain and partner satisfaction). Nonsurgical management can allow patients to avoid the morbidities associated with surgery and still achieve improved functional and aesthetic outcomes. In this article we explore the current non-surgical management options for PD including oral, mechanical therapies, intralesional and topical treatments. We also briefly discuss future treatment options in the form of stem cell therapy.
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Affiliation(s)
| | - C. J. Shukla
- Western General Hospital, Crewe Road South, Edinburgh, EH4 2XU, UK
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Nascimento B, Cerqueira I, Miranda EP, Bessa J, Ivanovic RF, Guglielmetti G, Nahas WC, Srougi M, Chiesa GA, Cury J. Impact of Camera Deviation on Penile Curvature Assessment Using 2D Pictures. J Sex Med 2018; 15:1638-1644. [DOI: 10.1016/j.jsxm.2018.08.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/16/2018] [Accepted: 08/31/2018] [Indexed: 10/27/2022]
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Bella AJ, Lee JC, Grober ED, Carrier S, Benard F, Brock GB. 2018 Canadian Urological Association guideline for Peyronie's disease and congenital penile curvature. Can Urol Assoc J 2018; 12:E197-E209. [PMID: 29792593 DOI: 10.5489/cuaj.5255] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Peyronie’s disease (PD) is a highly prevalent condition that affects the physical and psychosocial well-being and quality of life (QoL) for thousands of Canadian men. The specific etiology of PD remains poorly understood and there remains a paucity of randomized placebo-controlled trials evaluating treatment interventions.1-3 PD can be found in up to 8.9% of men, a remarkable increase in cited prevalence that is attributable to growing awareness (as historical data suggested a rate of less than 1%); the burden of disease is significant, and PD is often present in otherwise healthy men. The following guidelines were crafted by the committee with a full awareness of the limitations of the literature, and sought to provide actionable recommendations to guide PD care in the Canadian health system.
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Affiliation(s)
- Anthony J Bella
- Ottawa Urology and Men's Health and Ottawa Hospital Research Institute, Ottawa ON; Canada
| | - Jay C Lee
- Department of Surgery, Division of Urology, University of Calgary, Calgary, AB; Canada
| | - Ethan D Grober
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON; Canada
| | - Serge Carrier
- Division of Urology, McGill University Health Centre, Montreal, QC; Canada
| | - Francois Benard
- Department of Surgery, Université de Montreal, Montreal, QC; Canada
| | - Gerald B Brock
- Department of Surgery, Division of Urology Western University, London, ON; Canada
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Abdel Raheem A, Johnson M, Abdel-Raheem T, Capece M, Ralph D. Collagenase Clostridium histolyticum in the Treatment of Peyronie's Disease-A Review of the Literature and a New Modified Protocol. Sex Med Rev 2017; 5:529-535. [PMID: 28874327 DOI: 10.1016/j.sxmr.2017.07.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 06/18/2017] [Accepted: 07/10/2017] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Peyronie's disease (PD) is a common condition that results in penile deformity, which makes sexual intercourse difficult or impossible, and causes psychological, emotional, and relationship difficulties for the man affected and his partner. Collagenase Clostridium histolyticum (CCH; Xiapex, Xiaflex) is the first licensed non-surgical treatment option for PD. The safety and efficacy have been demonstrated in two large phase III randomized controlled trials (IMPRESS I and IMPRESS II). AIM To review the safety and efficacy of CCH and to introduce a new shortened modified protocol for CCH that was developed by the authors to decrease the cost and duration of treatment. METHODS A review of the medical literature on CCH for inclusion in this review was obtained by searching the PubMed (from 1946) and Medline (from 1946) medical databases and from the screening of relevant bibliographies. The search terms Xiapex, Xiaflex, collagenase Clostridial histolyticum, and Peyronie's disease were used. Clinical trials in men with PD and scientific articles relating to pharmacologic data were included in the review. When possible, large, randomized, and well-designed trials were selected. MAIN OUTCOME MEASURES Changes in the angle of penile curvature and in the Peyronie's Disease Questionnaire domains. RESULTS The clinical trials demonstrate the safety and efficacy of CCH in the treatment of PD. The new modified protocol developed by the authors is as safe and effective as the protocol used in the clinical trials. CONCLUSION CCH is the first licensed non-surgical treatment for PD. Its safety and efficacy have been demonstrated in large well-designed clinical trials. The new shortened modified protocol decreases the cost and duration of the treatment without compromising the safety and efficacy of the drug. This alteration will allow more patients to benefit from CCH. Abdel Raheem A, Johnson M, Abdel-Raheem T, et al. Collagenase Clostridium histolyticum in the Treatment of Peyronie's Disease-A Review of the Literature and a New Modified Protocol. Sex Med Rev 2017;5:529-535.
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Affiliation(s)
- Amr Abdel Raheem
- Andrology Department, The Institute of Urology and University College London Hospital, London, UK; Andrology Department, Cairo University Hospital, Cairo, Egypt.
| | - Mark Johnson
- Andrology Department, The Institute of Urology and University College London Hospital, London, UK
| | - Tarek Abdel-Raheem
- Andrology Department, The Institute of Urology and University College London Hospital, London, UK
| | - Marco Capece
- Andrology Department, The Institute of Urology and University College London Hospital, London, UK
| | - David Ralph
- Andrology Department, The Institute of Urology and University College London Hospital, London, UK
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Abdel Raheem A, Capece M, Kalejaiye O, Abdel-Raheem T, Falcone M, Johnson M, Ralph OG, Garaffa G, Christopher AN, Ralph DJ. Safety and effectiveness of collagenase clostridium histolyticum in the treatment of Peyronie's disease using a new modified shortened protocol. BJU Int 2017; 120:717-723. [DOI: 10.1111/bju.13932] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Amr Abdel Raheem
- Andrology Department; University College London Hospital and The Institute of Urology London and St Peter's Andrology Centre; London UK
- Andrology Department; Cairo University Hospital; Cairo Egypt
| | - Marco Capece
- Andrology Department; University College London Hospital and The Institute of Urology London and St Peter's Andrology Centre; London UK
| | - Odunayo Kalejaiye
- Andrology Department; University College London Hospital and The Institute of Urology London and St Peter's Andrology Centre; London UK
| | - Tarek Abdel-Raheem
- Andrology Department; University College London Hospital and The Institute of Urology London and St Peter's Andrology Centre; London UK
| | - Marco Falcone
- Andrology Department; University College London Hospital and The Institute of Urology London and St Peter's Andrology Centre; London UK
| | - Mark Johnson
- Andrology Department; University College London Hospital and The Institute of Urology London and St Peter's Andrology Centre; London UK
| | - Oliver G. Ralph
- Andrology Department; University College London Hospital and The Institute of Urology London and St Peter's Andrology Centre; London UK
| | - Giulio Garaffa
- Andrology Department; University College London Hospital and The Institute of Urology London and St Peter's Andrology Centre; London UK
| | - Andrew N. Christopher
- Andrology Department; University College London Hospital and The Institute of Urology London and St Peter's Andrology Centre; London UK
| | - David J. Ralph
- Andrology Department; University College London Hospital and The Institute of Urology London and St Peter's Andrology Centre; London UK
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Davis S, Ferrar S, Sadikaj G, Binik Y, Carrier S. Shame, Catastrophizing, and Negative Partner Responses Are Associated With Lower Sexual and Relationship Satisfaction and More Negative Affect in Men With Peyronie's Disease. JOURNAL OF SEX & MARITAL THERAPY 2017; 43:264-276. [PMID: 26836296 DOI: 10.1080/0092623x.2016.1147511] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Peyronie's disease (PD) has a negative impact on men's sexual functioning and quality of life, but little is known about why some men cope better than others and what the effects of PD are on their relationships. The aims of the present study were to describe negative affect, pain, and relationship and sexual satisfaction in men with PD, and to explore their psychosocial correlates. Participants were 110 men diagnosed with PD. All men completed questionnaires. The main outcome measures were as follows: Global Measure of Sexual Satisfaction, Dyadic Adjustment Scale, McGill Pain Questionnaire, and Negative Affect Scale. The predictor variables were the following: Experience of Shame Scale, Body Esteem Scale, Body Image Self-Consciousness Scale, Index of Male Genital Image, a modified Pain Catastrophizing Scale, and a modified Multidimensional Pain Inventory. Although men with PD had mean sexual/relationship satisfaction and negative affect scores indicating mild impairment, there was a wide range of variation, with 42% to 52% scoring in the clinical range. Catastrophizing was significantly associated with reduced sexual satisfaction and increased negative affect and pain. Shame was also associated with increased negative affect. The significant associations of relationship satisfaction were partner responses and shame. Given the lack of curative treatment in PD, understanding why some men cope better than others may guide therapy. Shame, catastrophizing, and partner responses may be important therapeutic targets.
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Affiliation(s)
- Seth Davis
- a Faculty of Medicine, University of Toronto , Toronto , Ontario , Canada
| | - Saskia Ferrar
- b Department of Psychology , Concordia University , Montreal , Quebec , Canada
| | - Gentiana Sadikaj
- c Department of Psychology , McGill University , Montreal , Quebec , Canada
| | - Yitzchak Binik
- c Department of Psychology , McGill University , Montreal , Quebec , Canada
| | - Serge Carrier
- d Department of Surgery, Division of Urology , McGill University Health Centre, McGill University , Montreal , Quebec , Canada
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Female Partners of Men With Peyronie's Disease Have Impaired Sexual Function, Satisfaction, and Mood, While Degree of Sexual Interference Is Associated With Worse Outcomes. J Sex Med 2016; 13:1095-103. [DOI: 10.1016/j.jsxm.2016.04.074] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 04/04/2016] [Accepted: 04/06/2016] [Indexed: 11/18/2022]
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