Chronic prostatitis as possible risk factor for Peyronie's disease (PD): psychological, sexual and prostatitis-like symptoms in patients with PD

Submitted: April 12, 2023
Accepted: May 11, 2023
Published: May 31, 2023
Abstract Views: 1505
PDF: 446
Supplementary material: 57
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Objective: This study aims to investigate a possible relationship between chronic prostatitis (CP) and Peyronie's disease (PD) and to characterize the psychological profile of patients suffering from PD, with or without concomitant CP. Methods: We included 539 patients with PD, of which 200 were found to have underlying CP. As a comparator population, we selected 2201 patients without PD, referring to our tertiary care clinic. In this population, we detected 384 subjects with CP. All 539 PD patients underwent photographic documentation of the penile deformation, and dynamic penile eco-color Doppler with plaque and volume measurements and answered the following questionnaires: the Generalized Anxiety Disorder-7, the Patient Health Questionnaire-9, the Visual Analog Scale for penile painmeasurements, the International Index of Erectile Function (IIEF), and the NIH-Chronic Prostatitis Symptom Index. Results: The overall prevalence of chronic prostatitis in PD patients was 37.1% compared to a prevalence of 17.4% in the non-PD control population (OR = 2.79 and p < 0.0001). The severity of CP symptom total scores (NIH-CPSI) correlated significantly with the severity of erectile dysfunction (p < 0.0001). Significant anxiety was present in 89.2% of PD patients and it is more prevalent in PD patients with CP than in PD patients without CP (93.0% vs. 87.0%, respectively; p = 0.0434). Significant depression was detected in 57.1% of PD patients and it is more prevalent in PD patients with CP than in PD patients without CP (64.0% vs. 53.09%, respectively; p = 0.0173). Conclusion: Chronic prostatitis (CP) and Peyronie's disease (PD) are frequently associated. Our results demonstrate the strong impact of chronic prostatitis on the mental status of PD patients. Anxiety and depression were significantly more pronounced in PD patients with CP than in PD patients without CP.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Billig R, Baker R, Immergut M, et al. Peyronie's disease. Urology. 1975; 6:409-418.
Solakhan M, Kısacık B. Is Peyronie's an IgG4-related disease? Eur J Rheumatol. 2021; 8:27-30.
Pastuszak AW, Rodriguez KM, Solomon ZJ, et al. Increased Risk of Incident Disease in Men with Peyronie's Disease: Analysis of U.S. Claims Data. J Sex Med. 2018; 15:894-901.
Paulis G, Romano G, Paulis A. Prevalence, psychological impact, and risk factors of erectile dysfunction in patients with Peyronie's disease: a retrospective analysis of 309 cases. Res Rep Urol. 2016; 8:95-103.
Casabé A, Bechara A, Cheliz G, et al. Risk factors of Peyronie's disease. What does our clinical experience show? J Sex Med. 2011; 8:518-523.
Paulis G, Conti E, Voliani S, et al. Evaluation of the cytokines in genital secretions of patients with chronic prostatitis. Arch Ital Urol Androl. 2003; 75:179-186.
Liang W, Wu Z, Zhang G, et al. A urine-based biomarker for chronic prostatitis/chronic pelvic pain syndrome: a retrospective multi-center study. Transl Androl Urol. 2020; 9:2218-2226.
Paulis G. Inflammatory mechanisms and oxidative stress in prostatitis: the possible role of antioxidant therapy. Res Rep Urol. 2018; 10:75-87.
Sikka SC, Hellstrom WJ. Role of oxidative stress and antioxidants in Peyronie's disease. Int J Impot Res. 2002; 14:353-360.
Paulis G, De Giorgio G, Paulis L. Role of Oxidative Stress in Peyronie's Disease: Biochemical Evidence and Experiences of Treatment with Antioxidants. Int J Mol Sci. 2022; 15; 23:15969.
Paulis G, Barletta D, Turchi P, et al. Efficacy and safety evaluation of pentoxifylline associated with other antioxidants in medical treatment of Peyronie's disease: a case-control study. Res Rep Urol. 2015; 8:1-10.
Franco JV, Turk T, Jung JH, et al. Pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome. Cochrane Database Syst Rev. 2019; 10:CD012552.
Yaryari AM, Mousavibahar SH, Amirhassani S, et al. Men suffering from category III chronic prostatitis may benefit from Nacetylcysteine as an adjunct to alpha-blockers. Low Urin Tract Symptoms. 2022; 14:199-207.
Wagenlehner FM, Schneider H, Ludwig M, et al. A pollen extract (Cernilton) in patients with inflammatory chronic prostatitis-chronic pelvic pain syndrome: a multicentre, randomised, prospective, double-blind, placebo-controlled phase 3 study. Eur Urol. 2009; 56:544-551.
Vicari E, Arancio A, Catania VE, et al. Resveratrol reduces inflammation-related Prostate Fibrosis. Int J Med Sci. 2020; 17:1864-1870.
Zimmermann RP, Feil G, Bock C, et al. Significant alterations of serum cytokine levels in patients with Peyronie's disease. Int Braz J Urol. 2008; 34:457-466.
Drachenberg DE, Elgamal AA, Rowbotham R, et al. Circulating levels of interleukin-6 in patients with hormone refractory prostate cancer. Prostate. 1999; 41:127-133.
John H, Barghorn A, Funke G, Sulser T, et al. Noninflammatory chronic pelvic pain syndrome: immunological study in blood, ejaculate and prostate tissue. Eur Urol. 2001; 39:72-8.
Bai J, Wang S, Liu J, et al. Characterization of circulating CD4+CD25high regulatory T cells in men with chronic prostatitis/ chronic pelvic pain syndrome. Urology. 2010; 75:938-942.
Jeon SW, Kim YK. The role of neuroinflammation and neurovascular dysfunction in major depressive disorder. J Inflamm Res. 2018; 11:179-192.
Kwon JK, Chang IH. Pain, catastrophizing, and depression in chronic prostatitis/chronic pelvic pain syndrome. Int Neurourol J. 2013; 17:48-58.
Revest JM, Dupret D, Koehl M, et al. Adult hippocampal neurogenesis is involved in anxiety-related behaviors. Mol Psychiatry. 2009; 14:959–967.
Pontari MA, Ruggieri MR. Mechanisms in prostatitis/chronic pelvic pain syndrome. J Urol. 2004; 172:839-845.
Watanabe T, Inoue M, Sasaki K, et al. Nerve growth factor level in the prostatic fluid of patients with chronic prostatitis/chronic pelvic pain syndrome is correlated with symptom severity and response to treatment. BJU Int. 2011; 108:248-251.
Miller LJ, Fischer KA, Goralnick SJ, et al. Nerve growth factor and chronic prostatitis/chronic pelvic pain syndrome. Urology. 2002; 59:603-608.
Yohannes E, Chang J, Tar MT, et al. Molecular targets for diabetes mellitus-associated erectile dysfunction. Mol Cell Proteomics. 2010; 9:565-578.
Dai YT, Chen Y, Yao LS, et al. Expression of nerve growth factor in cavernous tissue and its effects on the treatment of rats with diabetic erectile dysfunction. Zhonghua Nan Ke Xue. 2005; 11:748-751.
Wang CC, Liao CH, Liu HT, et al. Association of urinary nerve growth factor levels with erectile function in young men with type 2 diabetes mellitus. Int J Impot Res. 2017; 29:101-104.
Kalisch BE, Bock NA, Davis WL, Rylett RJ. Inhibitors of nitric oxide synthase attenuate nerve growth factor-mediated increases in choline acetyltransferase expression in PC12 cells. J Neurochem. 2002; 81:624-635.
Nelson CJ, Diblasio C, Kendirci M, et al. The chronology of depression and distress in men with Peyronie's disease. J Sex Med. 2008; 5:1985-1990.
Rosen R, Catania J, Lue T, et al. Impact of Peyronie's disease on sexual and psychosocial functioning: qualitative findings in patients and controls. J Sex Med. 2008; 5:1977-1984.
Hartzell R. Psychosexual Symptoms and Treatment of Peyronie's Disease Within a Collaborative Care Model. Sex Med. 2014; 2:168-177.
Nelson CJ, Mulhall JP. Psychological impact of Peyronie's disease: a review. J Sex Med. 2013; 10:653-660.
Terrier JE, Nelson CJ. Psychological aspects of Peyronie's disease. Transl Androl Urol. 2016; 5:290-295.
Smith JF, Walsh TJ, Conti SL, et al. Risk factors for emotional and relationship problems in Peyronie’s disease. J Sex Med. 2008; 5:2179-2184.
Paulis G, Paulis A, Perletti G. Congenital penile curvature as a possible risk factor for the onset of Peyronie's disease, and psychological consequences of penile curvature. Arch Ital Urol Androl. 2023; 95:11328.
Ahn SG, Kim SH, Chung KI, et al. Depression, anxiety, stress perception, and coping strategies in korean military patients with chronic prostatitis/chronic pelvic pain syn- drome. Korean J Urol. 2012; 53:643-648.
Miller HC. Stress prostatitis. Urology. 1988; 32:507-510.
Krsmanovic A, Tripp DA, Nickel JC, et al. Psychosocial mechanisms of the pain and quality of life relationship for chronic prostatitis/ chronic pelvic pain syndrome (CP/CPPS). Can Urol Assoc J. 2014; 8:403-408.
Bai J, Gu L, Chen Y, et al. Evaluation of psychological stress, cortisol awakening response, and heart rate variability in patients with chronic prostatitis/chronic pelvic pain syndrome complicated by lower urinary tract symptoms and erectile dysfunction. Front Psychol. 2022; 13:903250.
Zhang GX, Bai WJ, Xu T, et al. A preliminary evaluation of the psychometric profiles in Chinese men with chronic prostatitis/chronic pelvic pain syndrome. Chin Med J (Engl). 2011; 124:514-518.
Anderson RU, Orenberg EK, Chan CA, et al. Psychometric profiles and hypothalamic-pituitary adrenal axis function in men with chronic prostatitis/chronic pelvic pain syndrome. J Urol. 2008; 179:956-960.
Egan KJ, Krieger JN. Psychological problems in chronic prostatitis patients with pain. Clin J Pain. 1994; 10(3):218-226.Katz J, Melzack R. Measurement of pain. Surg Clin North Am. 1999; 79:231-252.
Sugimoto M, Hijikata Y, Tohi Y, et al. Low quality of life in men with chronic prostatitis-like symptoms. Prostate Cancer Prostatic Dis. 2022; 25:785-790.
Eri LM, Thomassen H, Brennhovd B, Håheim LL. Accuracy and repeatability of prostate volume measurements by transrectal ultrasound. Prostate Cancer Prostatic Dis. 2002; 5:273-278.
Lee JS, Chung BH. Transrectal ultrasound versus magnetic resonance imaging in the estimation of prostate volume as compared with radical prostatectomy specimens. Urol Int. 2007; 78:323-327.
Litwin MS, McNaughton-Collins M, Fowler FJ Jr, et al. The National Institutes of Health chronic prostatitis symptom index: development and validation of a new outcome measure. Chronic Prostatitis Collaborative Research Network. J Urol. 1999; 162:369-375.
Kahl C, Cleland JA. Visual analogue scale, numeric pain rating scale and the McGill pain Questionnaire: an overview of psychometric properties. Phys Ther Rev. 2005; 10:123-128.
Rosen RC, Riley A, Wagner G, et al. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997; 49:822-830.
Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006; 166:1092-1097.
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001; 16:606-613.
Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007; 39:175-91.
Bjekic MD, Vlajinac HD, Sipetic SB, et al. Risk factors for Peyronie's disease: a case-control study. BJU Int. 2006; 97:570-574.
Carrieri MP, Serraino D, Palmiotto F, et al. A case-control study on risk factors for Peyronie's disease. J Clin Epidemiol. 1998; 51:511-515.
La Pera G, Pescatori ES, Calabrese M, et al. SIMONA Study Group. Peyronie's disease: prevalence and association with cigarette smoking. A multicenter population-based study in men aged 50-69 years. Eur Urol. 2001; 40:525-530.
Tal R, Heck M, Teloken P, et al. Peyronie's disease following radical prostatectomy: incidence and predictors. J Sex Med. 2010; 7:1254-1261.
El-Sakka AI. Prevalence of Peyronie's disease among patients with erectile dysfunction. Eur Urol. 2006; 49:564-569.
Ventimiglia E, Capogrosso P, Colicchia M, et al. Peyronie's disease and autoimmunity—a real-life clinical study and comprehensive review. J Sex Med. 2015; 12:1062-1069.
Brookes ST, Link CL, Donovan JL, McKinlay JB. Relationship between lower urinary tract symptoms and erectile dysfunction: results from the Boston Area Community Health Survey. J Urol. 2008; 179:250-255.
Magri V, Perletti G, Montanari E, et al. Chronic prostatitis and erectile dysfunction: results from a cross-sectional study. Arch Ital Urol Androl. 2008; 80:172-1755.
Hao ZY, Li HJ, Wang ZP, et al. The prevalence of erectile dysfunction and its relation to chronic prostatitis in Chinese men. J Androl. 2011; 32:496-501.
Shoskes DA. The challenge of erectile dysfunction in the man with chronic prostatitis/chronic pelvic pain syndrome. Curr Urol Rep. 2012; 13:263-267.
Zhang Z, Li Z, Yu Q, et al. The prevalence of and risk factors for prostatitis-like symptoms and its relation to erectile dysfunction in Chinese men. Andrology. 2015; 3:1119-1124.
Zhang Y, Zheng T, Tu X, et al. Erectile Dysfunction in Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Outcomes from a Multi- Center Study and Risk Factor Analysis in a Single Center. PLoS One. 2016; 11:e0153054.
Magri V, Boltri M, Cai T, et al. Multidisciplinary approach to prostatitis. Arch Ital Urol Androl. 2019; 90:227-248.

How to Cite

Paulis, G., & Paulis, A. (2023). Chronic prostatitis as possible risk factor for Peyronie’s disease (PD): psychological, sexual and prostatitis-like symptoms in patients with PD. Archivio Italiano Di Urologia E Andrologia, 95(2). https://doi.org/10.4081/aiua.2023.11406