Prevalence of self-reported erectile dysfunction at first medical assessment in men with Peyronie’s disease – Preliminary findings of a real-life cross-sectional study
Pederzoli, F1; Capogrosso, P1; Ventimiglia, E1; Boeri, L2; Cazzaniga, W1; Chierigo, F1; Pozzi, E1; Frego, N1; Moretti, D1; Dehò, F1; Montanari, E2; Gaboardi, F1; Mirone, V3; Montorsi, F1; Salonia, A1
1: San Raffaele Hospital, Italy; 2: University of Milan, Italy; 3: University of Naples Federico II, Italy
Objectives: To investigate the prevalence of self-reported erectile dysfunction (ED) in a cohort of men seeking first medical help for Peyronie’s disease (PD) at a tertiary referral center.
Materials and Methods: Demographic, clinical and laboratory data from 327 consecutive men primarily referring for PD were analyzed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Hypertension was defined as blood pressure >140/90 mmHg. Patients were asked to complete the International index of Erectile Function (IIEF), the Peyronie's Disease Questionnaire (PDQ), the Beck Inventory for Depression (BDI; clinical depression for BDI>16), and the Index of Prostate Symptom Score (IPSS). IIEF was categorized according to Cappelleri’s criteria. Hypogonadism was defined as total testosterone <3 ng/ml.
Results: Of all, 160 (49%) men self-reported to have ED at their first clinical assessment. In the PD+ with self-reported ED (PD/ED+) cohort, normal EF, mild, mild-to-moderate, moderate and severe ED was found in 98 (58.7%), 17 (10.2%), 13 (7.7%), 17 (10.2%) and 22 (13.2%), respectively. Conversely, in PD/ED- men, normal EF, mild, mild-to-moderate, moderate and severe ED was found in 28 (17.5%), 28 (17.5%), 25 (15.7%), 21 (13.1%) and 58 (36.2%), respectively. PD/ED+ more frequently depicted IIEF-EF scores suggestive of severe ED compared to PD/ED- patients (p<0.001). PD/ED+ and PD/ED- patients did not differ in terms of age, BMI and rate of hypogonadism (15.4 vs. 13.3%). Conversely, PD/ED+ patients had higher rate of CCI≥1 (p<0.001) and hypertension (p=0.004). No differences were found between groups in terms of PDQ domains; conversely, PD/ED+ patients more commonly reported higher BDI scores than PD/ED- (9.2 vs. 6.0, p=0.01), without differences in terms of clinical depression. PD/ED+ patients more commonly complained about concomitant LUTS (25.2% vs. 14.0%, p=0.01), although IPSS failed to objectively record the difference.
Conclusions: Almost 50% of patients seeking first medical help for PD suffer from self-reported ED. Overall, PD/ED+ patients are generally less healthy, more frequently complain of concomitant LUTS and a depressive mood than PD without self-reported ED. Of clinical relevance, physicians must be aware of the high rate of both self-reported and not-self-reported ED among PD patients to tailoring the more appropriate treatment accordingly.
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