Psychological impact of Peyronie's disease: a review.

INTRODUCTION: Peyronie's disease (PD) is characterized by an accumulation of scar tissue in the tunica albuginea of the penis that causes curvature and deformity. PD can result in psychological distress, depression, or anxiety, which often goes untreated. AIMS: To review the current literature on the psychological impact of PD, educate healthcare providers about the psychological components of the disease, and propose interventions that address the psychological and sexual challenges patients and their partners may encounter.
METHODS: We performed a MEDLINE search, limited to English, using the terms "Peyronie's disease" AND "psychological" OR "psychosocial," and select references were included for review. MAIN OUTCOME MEASURE: Critical review of the currently available English language literature.
RESULTS: PD and its associated deformity often impairs sexual relations and frequently leads to psychological and psychosocial sequelae for affected individuals. Many men experience depression, low self-esteem, and emotional distress; these problems markedly diminish the quality of life for affected individuals. The literature suggests that as many as 81% of men report "emotional difficulties," 48% report clinically meaningful depression (26% moderate; 21% severe), and 54% report relationship problems due to PD. The challenges imposed by PD include alterations in sexual relationships, restrictions on intimacy, social isolation, and stigmatization, all of which are linked and reinforce each other. Physicians may be unaware of the psychological sequelae suffered by patients and their partners.
CONCLUSIONS: Improved awareness and education about the psychological consequences and treatment options for PD are necessary among healthcare providers. To best help patients and optimize outcomes, a team-based approach is needed that includes psychosocial assessment and appropriate resource referrals for the patient and his sexual partner.