title: Risk factors for emotional and relationship problems in Peyronie's disease.
abstract: BACKGROUND
  Peyronie's disease (PD) occurs in 3-9% of all men. Little is known regarding the specific psychological or emotional disruptions to sexuality associated with PD.
  
  
  OBJECTIVE
  Our primary aim was to identify risk factors associated with psychosocial difficulties in men with PD.
  
  
  METHODS
  This cross-sectional study enrolled patients from a single clinical practice. Detailed medical histories, physical examinations, and a PD-specific questionnaire were used to define clinical characteristics. Odds ratios (ORs) were used as a measure of association.
  
  
  METHODS
  Emotional and relationship problems were determined by "yes" or "no" answers to two specific questions.
  
  
  RESULTS
  The mean age of all PD patients (N = 245) was 54.4 years (range 19.4-75.6); 62% were married, and 59% presented within 2 years of disease onset. The overall prevalence of emotional and relationship problems attributable to PD was 81% and 54%, respectively. Among men who had relationship problems, the prevalence of emotional problems was 93%. In men with emotional problems due to PD, relationship issues were observed in 62%. Multivariable analysis revealed that emotional difficulties (OR 6.9, P < 0.001) and ability to have intercourse (OR 0.4, P = 0.004) were independently associated with relationship problems. Relationship problems (OR 8.0, P < 0.001) and loss of penile length (OR 2.7, P = 0.02) were significant independent predictors of emotional problems after adjustment for the ability to maintain erections, low libido, and penile pain.
  
  
  CONCLUSIONS
  Among men with PD, there is a very high prevalence of emotional and relationship problems. Loss of penile length and inability to have intercourse are strong predictors of these problems and as such make ideal targets for intervention. Medical and surgical therapies may enhance quality of life through their ability to improve sexual function. Further research will characterize the ways in which individual symptoms affect emotional and psychological well-being.
authors.affiliation: University of California, San Francisco-Urology, San Francisco, CA, USA. smithjf@urology.ucsf.edu
authors.forename: James F
authors.initials: JF
authors.lastname: Smith
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Walsh
authors.forename: Simon L
authors.initials: SL
authors.lastname: Conti
authors.forename: Paul
authors.initials: P
authors.lastname: Turek
authors.forename: Tom
authors.initials: T
authors.lastname: Lue
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis / Q000523:psychology*; D000368:Aged; D003075:Coitus / Q000523:psychology; D003430:Cross-Sectional Studies; D007172:Erectile Dysfunction / Q000523:psychology; D006801:Humans; D055809:Illness Behavior; D007398:Interpersonal Relations; D007989:Libido; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology; D010411:Penile Induration / Q000523:psychology*; D012307:Risk Factors; D012735:Sexual Dysfunction, Physiological / Q000523:psychology*; D055815:Young Adult