The clinical and psychosocial impact of Peyronie's disease.

Peyronie's disease (PD) is characterized by the formation of palpable fibrotic tissue in the tunica albuginea of the penis. It is thought to manifest in response to recurrent microtrauma during erection in those with risk factors that may include wound-healing disorders. The initial stage of PD is thought to last from 6 to 18 months, and it is characterized by an inflammatory period with pain in approximately one-third of men. This initial phase is followed by a chronic phase when pain typically resolves and the deformity stabilizes with no additional plaque development. PD has been reported to develop in up to 9% of adult males according to published literature, but the incidence may be even higher. The most frequently affected age group is men between 50 and 59 years. Because of the associated penile deformity and effect on sexual relations, psychosocial distress is very common in those with PD. It has been reported to negatively affect self-image, sexual activity, intimacy, and mood, and it is often associated with depression and erectile dysfunction (ED). At this time, nonsurgical treatments are unreliable and have variable efficacy, and surgical treatments are reserved for those with disabling disfigurement. Moreover, surgery may result in loss of penile length and ED, and there are only a few physicians in the United States that perform such surgeries. There is a great need to increase awareness of PD in patients and general practitioners, to elucidate the pathogenesis of PD, and for the development of novel treatments for this disfiguring disease.