The Prevalence of Peyronie's Disease in the United States: A Population-Based Study

Peyronie’s disease (PD) is a connective tissue disorder which can result in penile deformity. The prevalence of diagnosed PD in the United States (US) has been estimated to be 0.5% in adult males, but there is limited additional information comparing definitive and probable PD cases. 

We conducted a population-based survey to assess PD prevalence using a convenience-sample of adult men participating in the ResearchNow general population panel. Respondents were categorized according to PD status (definitive, probable, no PD) and segmented by US geographic region, education, and income levels. 

Of the 7,711 respondents, 57 (0.7%) had definitive PD while 850 (11.0%) had probable PD. Using univariate logistic regression modeling, older age (18–24 vs 24+), Midwest/Northeast/West geographic region (South vs Midwest/Northeast/West), and higher income level (<25K vs 25K+) were each significantly associated with reduced odds of having a definitive/probable PD diagnosis compared with no PD diagnosis. When all three variables were entered in a stepwise multivariable logistic regression, only age and region remained significant. 

This study is the first to report PD prevalence by geographic region and income, and it advocates that the prevalence of PD in the US may be higher than previously cited. Further, given the large discrepancy between definitive PD cases diagnosed by a physician and probable cases not diagnosed by a physician, much more needs to be done to raise awareness of this disease.

Below:  PD prevalence by demographic subgroups

Full article at:  http://goo.gl/RBcG5m

By:  

Mark Stuntz, Anna Perlaky, Dan Glass 
Deerfield Institute, New York, New York, United States of America

Franka des Vignes 

Formerly at Deerfield Institute, New York, New York, United States of America

Tassos Kyriakides 

Yale Center for Analytical Services, Yale School of Public Health, New Haven, Connecticut, United States of America 

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Why Are Men Satisfied or Dissatisfied with Penile Implants? A Mixed Method Study on Satisfaction with Penile Prosthesis Implantation

Introduction

Studies have demonstrated high levels of satisfaction with penile prosthesis implantation (PPI). However, qualitative research exploring the experience of PPI through men's narratives is scarce.

Aim

The main goals were to analyze (i) the level of sexual satisfaction (quantitatively), and (ii) the reasons for satisfaction and/or dissatisfaction with PPI (qualitatively).

Method
Participants were 47 men with erectile dysfunction who underwent surgery between 2003 and 2012, placed by a single surgeon. Structured telephone interviews were carried out.

Main Outcome Measures

Satisfaction with PPI was a qualitative and quantitative measure assessed through the following four items: (i) “Would you repeat the PPI surgery?”; (ii) “Would you recommend the PPI surgery?”; (iii) “How satisfied are you with the PP?”; and (iv) “Could you explain the motives of your satisfaction/dissatisfaction?”.

Results

The majority of men (79%) reported to be satisfied with PPI. Content analysis revealed four main themes for men's satisfaction with the PPI: (i) psychological factors were reported 54 times (n = 54) and included positive emotions, self-esteem, confidence, enhancement of male identity, major live change, and self-image; (ii) improvement of sexual function was reported 54 times (n = 54) and referred to achievement of vaginal penetration, increase of sexual desire, sexual satisfaction, penis size, and improvement of erectile function; (iii) relationship factors were reported 11 times (n = 11) and referred to relationship improvement and the possibility of giving pleasure to the partner; and (iv) improvement in urinary function (n = 3).

Conclusions

The level of satisfaction with the implementation of penile prostheses is very high, therefore constituting a treatment for erectile dysfunction with a positive impact on the experience of men at sexual, psychological and relational level.

Full article at: http://goo.gl/y1erz8

By:   Ana Carvalheira PhD^1,,Rita Santana MA²and Nuno M. Pereira PhD³

William James Center for Research, ISPA—University Institute, Lisbon, Portugal

ISPA-University Institute, Lisbon, Portugal

iSex-Association of Advanced Study of Human Sexuality, Lusófona University, Lisbon, Portugal

*Corresponding Author: Ana Carvalheira, PhD, William James Center for Research, ISPA—University Institute, R. Jardim do Tabaco 34, 1149-041 Lisbon, Portugal. Tel: +351 919 253 757; Fax: +351-218-860-954; E-mail: acarvalheira@ispa.pt  

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Penile Prosthesis Implantation in Patients with a History of Total Phallic Construction

INTRODUCTION:

Outcomes following penile prosthesis implantation in patients with a history of total phallic construction are not well described.

AIM:

The aim of this study was to evaluate outcomes following neophallus penile prosthesis placement.

METHODS:

Retrospective review penile prosthesis placement in patients with prior total phallic construction. GORE-TEX® (Gore Medical, Flagstaff, AZ) sleeve neotunica construction was utilized in all patients.

MAIN OUTCOME MEASURE:

Success defined as patient sexual activity with a functioning prosthesis.

RESULTS:

Thirty-one patients underwent neophallic prosthesis implantation at a mean 35.6 years of age. Prosthesis placement occurred at an average 56.3 months following phallic construction and follow-up was a mean of 59.7 months. Malleable prostheses were placed in 21 patients and inflatable in 10; implants were bilateral in 94%. Six percent experienced operative complications including a bladder injury (1) and phallic flap arterial injury (1). Postoperative complications occurred in 23% at a median 5.5 months following placement. Five prostheses were explanted secondary to infection or erosion and two additional required revisions. Of the explanted prosthesis two were later replaced without further complication. Eighty-one percent of patients were sexually active following prosthesis placement.

CONCLUSIONS:

Penile prosthesis placement is possible in patients with prior penile reconstruction/phallic construction. Although complications rates appear to be elevated in this population compared with historic controls of normal anatomic men, the majority of patients in this series were sexually active following prosthesis placement. This demonstrates the utility of prosthesis implantation in these difficult patients. 

Purchase full article at:  http://goo.gl/01W6IW

By:   Zuckerman JM1, Smentkowski K2, Gilbert D3, Storme O2, Jordan G2, Virasoro R2, Tonkin J2, McCammon K2.

• 1Department of Urology, Naval Medical Center San Diego, San Diego, CA, USA.
• 2Department of Urology, Eastern Virginia Medical School, Norfolk, VA, USA.
• 3Department of Plastic and Reconstructive Surgery, Eastern Virginia Medical School, Norfolk, VA, USA. 

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