To evaluate clinical characteristics associated with patient attitudes towards surgical treatment of Peyronie's disease (PD) prior to consultation in a high-volume male sexual health clinic.
From 2014-2018 a prospective database was created of patients presenting to the sexual health clinic at our institution. Multivariable regression analysis was conducted to determine factors associated with pre-visit consideration of surgery.
Of 1359 men presenting to clinic, 342 had a chief complaint of PD. Prior to consultation, 79% of patients (n=270) stated they were willing to consider surgery to correct their PD symptoms. Factors associated with consideration of surgery included younger patient age (mean 55.8 vs 60.0 years; p=0.008), history of depression/anxiety (21% vs 8%, p=0.01), greater penile curvature (43.3 vs 34.6 degrees; p=0.002), penile shortening (64% vs 44%; p=0.003), pain with erections (46% vs 33%; p=0.05) and decreased ability to have penetrative intercourse (51.9% vs 65.3%, p=0.04). On multivariable analysis, age, history of depression, penile shortening and mean curvature remained significantly associated. Symptom duration and relationship factors were not associated with a difference in the stated preference to consider surgery prior to consultation (p>0.05 for all).
Nearly four out of five patients reported willingness to consider surgical intervention for their PD-related symptoms prior to urologic consultation. On multivariable analysis, younger age, history of depression/anxiety, penile shortening and curvature were associated with a greater likelihood of considering surgery. This information provides important insight into patient attitude towards undergoing surgery and will help drive patient counseling for men with PD.
Urology. 2021 Mar 04 [Epub ahead of print]
R Bole, M Jimbo, N Parikh, C Britton, A Gopalakrishna, D Yang, L Trost, S Helo, T S Kohler, M J Ziegelmann
Department of Urology, Mayo Clinic, Rochester, MN, USA. Electronic address: ., Department of Urology, Mayo Clinic, Rochester, MN, USA.