Changes in girth do not greatly affect psychosocial health in men with Peyronie’s disease, reports a recent Journal of Sexual Medicine study.
After a multivariate analysis, the researchers determined that “only degree of curvature was predictive of significant bother.”
“This implies that curvature is the most bothersome aspect of [Peyronie’s disease], as the degree of curvature has more of a psychosocial impact than even significant girth changes,” the authors wrote.
Believed to be a wound healing disorder, Peyronie’s disease is marked by areas of scar tissue called plaques that make the penis less elastic. The result is penile deformity, usually a significant curve. However, other types of deformities are possible, such as indentations and hinge effects.
Another is penile tapering, when girth measurements vary along the shaft. A “bottleneck” deformity occurs when the distal shaft (toward the tip) is narrower than the base (nearer the body). In contrast, a “cobra head” deformity occurs when the base is narrower than the distal shaft.
Men with Peyronie’s disease may also experience pain, have problems with erections, and struggle with psychological and social issues. For some, intercourse is difficult or impossible, and relationships can suffer. Low confidence and low self-esteem are common.
The study included 131 men with Peyronie’s disease who were seen at one sexual medicine clinic from 2014 to 2019. The men ranged in age from 31 to 78 years, with an average age of 59. The average duration of their Peyronie’s disease was 16 months, and all had midshaft curvature (average of 37 degrees).
Stretched penile length, girth, and instability (based on the significance of buckling in the penis) were all noted. The men also completed three assessment tools: the Peyronie’s Disease Questionnaire (PDQ), the Self-Esteem and Relationship Questionnaire (SEAR), and the Center for Epidemiologic Studies Depression Scale (CES-D).
Overall, the mean girth measurement between the base of the penis and the point of maximum curvature was 0.78 centimeters, representing a 6% difference. Fifty-four men had a girth difference of at least one centimeter, and 23 men had a change in girth of at least 10 percent. Instability was reported in 53%.
Scores on the three questionnaires indicated that in general, changes in girth did not have negative effects on the men. Degrees of bother were similar regardless of girth differences. However, men with a girth difference of 10% or greater had higher rates of depression.
The study is among the first (and largest) to investigate the effects of girth differences in men with Peyronie’s disease, they added. However, they acknowledged that the sample size was small and that larger studies might show greater psychosocial impact.
The findings may assist clinicians who counsel men with Peyronie’s disease.
The Journal of Sexual Medicine
Salter, Carolyn A., MD, et al.
“Evaluating the Impact of Penile Girth Discrepancy on Patient Bother in Men With Peyronie’s Disease: An Observational Study”
(Full-text. Published: June 20, 2020)