Paulis Gianni, Paulis Andrea, Perletti Gianpaolo
Peyronie's Care Center, Department of Uro-Andrology, Castelfidardo Clinical Analysis Center, Rome.
Neurosystem Center for applied Psychology and Neuroscience, Janet Clinical Centre, Rome.
Arch Ital Urol Androl. 2023 Mar 15;95(1):11238. doi: 10.4081/aiua.2023.11238.
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.
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.
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).
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.
研究先天性阴茎弯曲（CPC）病史与佩罗尼氏病（PD）之间可能存在的关系，并描述患有PD的患者（无论是否伴有CPC）的心理特征。
我们纳入了519例佩罗尼氏病（PD）患者，其中73例被发现存在潜在的CPC。作为对照人群，我们从三级医疗诊所选取了2166例无PD的患者。在该人群中，我们检测到15例患有CPC的患者。所有患者均完成了GAD - 7（广泛性焦虑症 - 7个问题）和PHQ - 9（患者健康问卷 - 9个问题）问卷。
PD患者中CPC的总体患病率为14.07%，而非PD对照人群中的患病率为0.69%（p < 0.00001）。在所有PD患者中，发现89.4%存在中度至重度焦虑。与单纯患有PD的患者相比，伴有CPC的PD患者中出现严重焦虑的比例显著更高（分别为57.5%和36.7%，p = 0.0008）。在所有PD患者中，发现57.8%存在中度至重度抑郁。与单纯患有PD的患者相比，有CPC病史的PD患者出现严重抑郁的比例显著更高（分别为13.6%和3.36%，p < 0.0002）。阴茎弯曲更严重（> 45°）的患者GAD - 7中位数得分显著更高（p = 0.029）。基于PD的严重程度，我们未检测到PHQ - 9中位数得分之间存在统计学显著差异（p = 0.53）。对PHQ - 9和GAD - 7中位数得分的分析显示，年轻患者的抑郁和焦虑症状明显更严重（分别为p < 0.001和p = 0.0013）。
先天性阴茎弯曲的存在可能是随后发生佩罗尼氏病的一个危险因素。在很大一部分病例中报告了中度/重度焦虑和中度/重度抑郁。阴茎弯曲更严重的患者焦虑明显更高，而抑郁的出现与阴茎弯曲程度无关。抑郁和焦虑在年轻受试者中更严重。
