Paulis Gianni, De Giorgio Giovanni, Paulis Andrea
Department of Urology and Andrology, Peyronie's Care Center, Castelfidardo Clinical Analysis Center, 00185 Rome, Italy.
Section of Ultrasound Diagnostics, Department of Urology and Andrology, Castelfidardo Clinical Analysis Center, 00185 Rome, Italy.
Diagnostics (Basel). 2024 May 29;14(11):1125. doi: 10.3390/diagnostics14111125.
Peyronie's disease (PD) affects the penile albuginea, resulting in penile deformity, pain, erectile dysfunction (ED), and an anxious-depressive state. PD diagnosis involves a thorough medical history, penile palpation, documentation of the penile deformation, a dynamic penile echo color Doppler ultrasound (PCDU), and the completion of questionnaires for the evaluation of pain, ED, and psychometric tests. The aim of this study was to evaluate the symptoms of PD and their prevalence in PD patients in the active phase who had access to our andrology clinic. Inclusion criteria: availability of data on patients diagnosed with PD, including detailed medical history, blood tests, penile palpation, photographic documentation of penile deformity, and penile PCDU. Exclusion criteria: PD patients in the stable phase or those without the specified tests and data mentioned above. Our study found a higher prevalence of PD in younger patients (24.2%), a higher coexistence of PD with chronic prostatitis (35.6%), a higher percentage of cases of association between penile deformity and penile curvature (84.4%), a higher prevalence of "significant anxiety" (88.4%), a higher presence of plaque calcification (35.6%), and the detection of a longer duration of the first phase of PD (>18 months). The most frequently observed type of penile curvature was dorsal, followed by left lateral, right lateral, and, less commonly, ventral. We observed a significant statistical correlation between patient age and IIEF score, indicating that patients over the age of 40 years are at a higher risk of experiencing ED. We found a strong statistical relationship between VAS score and age. As age increases, the VAS score decreases, suggesting that younger patients reported more penile pain compared to those who were older than 40 years. Furthermore, we found that penile pain has a significant impact on the psychological state of PD patients. We also found that 38.8% of PD patients suffered from severe anxiety. In relation to this, psychotherapy should be integrated into PD treatment to improve the quality of life and treatment adherence.
佩罗尼氏病（PD）会影响阴茎白膜，导致阴茎畸形、疼痛、勃起功能障碍（ED）以及焦虑抑郁状态。PD的诊断包括详尽的病史、阴茎触诊、阴茎畸形记录、动态阴茎彩色多普勒超声检查（PCDU），以及完成用于评估疼痛、ED和心理测试的问卷。本研究的目的是评估活跃期且能前往我们男科诊所就诊的PD患者的症状及其患病率。纳入标准：有确诊为PD患者的数据，包括详细病史、血液检查、阴茎触诊、阴茎畸形的照片记录以及阴茎PCDU检查。排除标准：处于稳定期的PD患者或没有上述特定检查和数据的患者。我们的研究发现，年轻患者中PD的患病率较高（24.2%），PD与慢性前列腺炎共存的比例较高（35.6%），阴茎畸形与阴茎弯曲相关病例的比例较高（84.4%），“严重焦虑”的患病率较高（88.4%），斑块钙化的比例较高（35.6%），且PD第一阶段的持续时间较长（>18个月）。最常见的阴茎弯曲类型是背侧，其次是左侧、右侧，较少见的是腹侧。我们观察到患者年龄与国际勃起功能指数（IIEF）评分之间存在显著的统计学相关性，表明40岁以上的患者发生ED的风险更高。我们发现视觉模拟评分（VAS）与年龄之间存在很强的统计学关系。随着年龄的增加，VAS评分降低，这表明与40岁以上的患者相比，年轻患者报告的阴茎疼痛更多。此外，我们发现阴茎疼痛对PD患者的心理状态有显著影响。我们还发现38.8%的PD患者患有严重焦虑。与此相关的是，应将心理治疗纳入PD治疗，以提高生活质量和治疗依从性。
