A Review of Treatment-Related Outcomes in Female Partners of Men With Peyronie's Disease—An Opportunity for Improved Assessment

Comparing and Contrasting Peyronie's Disease Guidelines: Points of Consensus and Deviation

BACKGROUND

Peyronie's disease (PD) is a challenging clinical entity. To assist clinicians with diagnosis and management, four separate organizations have published PD guidelines over the past five years, but there remains a lack of consensus and data-driven recommendations for many aspects of diagnosis and treatment.

AIM

To compare and contrast PD guidelines, highlighting key similarities and differences among the guideline panel recommendations and identify areas for further research.

METHODS

We performed an extensive review to compare and contrast diagnosis and treatment recommendations from publically available published PD guidelines from four different organizations: American Urological Association, European Association of Urology, Canadian Urologic Association, and the International Society of Sexual Medicine.

OUTCOMES

Key similarities and differences with regards to definition, evaluation, nonsurgical and surgical treatments were compared.

RESULTS

Points of general consensus among the guideline panels included: History is adequate for diagnosis of PD, and intracavernosal injection is a gold standard to evaluate penile deformity prior to invasive intervention. Careful counseling with shared decision-making is required prior to treatment. In general, plication and incision and/or grafting surgery is reserved for patients with preserved erectile function whereas penile prosthesis implantation is the only surgical option for PD patients with erectile dysfunction. Overall, nonsurgical treatments have inferior evidence of efficacy with these being the main area of controversy; however, all societies recognize that intralesional injections may be used. 0Further research into the pathophysiology of PD may direct novel treatments targeted towards early intervention and rigorous outcomes research may direct best practices for the surgical treatment of PD in the future.

CLINICAL IMPLICATIONS

PD is a challenging clinical entity. Direct comparison of the published PD guidelines highlights clear standards of care as well as areas where more research is needed to promote higher levels of evidence-based practice.

STRENGTHS & LIMITATIONS

To our knowledge this is the first report to directly compare and contrast published guidelines pertaining to the diagnosis and management of PD. Limitations include the lack of evidence-quality review pertaining to individual guideline recommendations, although this was not the aim of this review.

CONCLUSION

We highlight consensus of major urologic societies on many aspects of work up and management of PD with notable exceptions which may guide further research. Manka MG, White LA, Yafi FA, et al. Comparing and Contrasting Peyronie's Disease Guidelines: Points of Consensus and Deviation. J Sex Med 2021;18:363-375.

Peyronie's Disease: What About the Female Sexual Partner?

INTRODUCTION

Peyronie's disease (PD) is an acquired wound-healing disorder of the penis involving fibrosis and scar formation within the tunica albuginea that can lead to various penile deformities resulting in penile pain, sexual dysfunction, low self-esteem, and emotional distress. While many studies highlight the psychosocial impact of PD on the patient, little is known about the female partner's experience regarding PD and its management.

OBJECTIVES

To evaluate and summarize the available clinical data on the effects of the disease and its management on female sexual partners of patients with PD.

METHODS

A search of the available medical literature using the MEDLINE and PubMed databases was performed. The queried terms included the following: Peyronie's disease, partner, female, dyspareunia, relationship, satisfaction, survey, and outcome. Studies were included only if the female sexual partners were directly evaluated or interviewed.

RESULTS

PD can have a significant impact on the sexual function and satisfaction of female sexual partners. Most female sexual partners reported an improvement in their relationship, a decrease in sexual dysfunction, and improved overall satisfaction after both surgical and nonsurgical treatment.

CONCLUSION

PD can be emotionally debilitating for patients and their partners. It has been associated with depression, social stigmatization, isolation, diminished self-worth, and avoidance of intimacy. A partner's experience with PD, as well as its management and outcomes, is an understudied entity that warrants further investigation and may be useful in guiding future treatment approaches. Kern T, Ye N, Abdelsayed GA. Peyronie's Disease: What About the Female Sexual Partner?. Sex Med Rev 2021;9:230-235.