Farrell Michael Ryan, Corder Christopher J, Levine Laurence A
Department of Urology, Rush University Medical Center, Chicago, IL 60612, USA.
J Sex Med. 2013 Aug;10(8):2077-83. doi: 10.1111/jsm.12202. Epub 2013 May 16.
We describe the characteristics of Peyronie's disease (PD) and its associated psychosocial implications in men who have sex with men (MSM).
The 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.
Subjective and objective presenting characteristics, MSM psychosocial factors.
We 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.
A 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.
Few 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.
我们描述了佩罗尼氏病（PD）的特征及其在男男性行为者（MSM）中的相关社会心理影响。
本文旨在确定患有PD的MSM的表现特征和治疗方法，将这些结果与非MSM的PD患者进行比较，并确定PD对MSM的社会心理影响。
主观和客观表现特征，MSM的社会心理因素。
通过回顾性病历审查，我们确定了2000年至2012年间出现的27例患有PD的MSM。随机选择了200例在同一时期出现的非MSM PD患者。向患有PD的MSM患者发放了一份前瞻性未经验证的问卷，以评估社会心理结构。
在MSM和非MSM中，导致PD激活的创伤性事件的发生率相同（P = 0.815）。MSM中最常见的公认的PD激活因素是：插入式性交（22.2%），自我刺激（11.1%）。更多的MSM以阴茎畸形为主要诉求，包括变窄、凹陷、沙漏形和铰链形（11.1%的MSM vs. 1.0%的非MSM，P = 0.01）。在总曲率、勃起等级方面未发现差异（P > 0.05）。PD对情绪状态有负面影响（89.0%的MSM，80.5%的非MSM，P > 0.05），对亲密关系也有负面影响（45.0%的MSM，64.0%的非MSM，P > 0.05）。88.9%的MSM和76.5%的非MSM接受了非手术治疗（P > 0.05），29.6%的MSM和25.0%的非MSM接受了矫正手术（P > 0.05）。在进行肛交的75.0%的MSM中，41.7%报告插入式肛交是PD的激活因素。在MSM中，31.3%的人性欲下降，50.0%的人性行为频率下降，92.9%的人对自己阴茎的外观感到难为情，92.9%的人对自己阴茎的大小不满意。
MSM和非MSM PD患者在临床表现和治疗方法上几乎没有差异。两组均有情绪困扰的证据。因此，在有指征时，性心理评估和治疗应被视为对患有PD的患者至关重要。
