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Risk of childlessness in help-seeking men with Peyronie's disease-A Swedish longitudinal study
Ralf Kuja-Halkola1, Lars Henningsohn2, Brendan Zietsch3
1Department of Medical Epidemiology and Biostatistics (Solna), Karolinska Institutet, Stockholm, Sweden.
Insights
Peyronie's disease (PD) may affect men's chances of having children. Younger men with PD showed a slightly higher risk of childlessness, while older men had a slightly lower risk.
Area of Science:
- Urology
- Reproductive Health
- Men's Health
Background:
- Peyronie's disease (PD) is linked to reduced quality of life and sexual well-being.
- The impact of PD on fertility and the risk of childlessness remains under-researched.
- Understanding fertility outcomes is crucial for comprehensive PD patient care.
Purpose of the Study:
- To investigate the association between Peyronie's disease and the risk of childlessness.
- To analyze the rate of offspring in men diagnosed with PD compared to the general population.
- To identify potential age-related differences in fertility outcomes for men with PD.
Main Methods:
- Longitudinal cohort study using Swedish national registers.
- Inclusion of a large sample of men seeking help for PD and matched controls.
- Statistical analysis using logistic and Poisson regression models to assess childlessness and offspring rates.
Main Results:
- Men with PD aged 35-71 showed a slightly decreased probability of childlessness (OR 0.5-1.0).
- Men with PD aged 35 or younger exhibited a slightly increased probability of childlessness (OR 1-1.5).
- Offspring rates mirrored these trends, with higher rates in older men and lower rates in younger men with PD.
Conclusions:
- Peyronie's disease may influence childlessness risk, particularly in younger men.
- Clinical practice could benefit from proactive discussions regarding fertility in younger men with PD.
- Further research is warranted to fully elucidate the relationship between PD and reproductive outcomes.
Abstract:
Peyronie's disease (PD) is a disorder of the penis that is associated with poor mental health, lowered psychosocial- and sexual wellbeing, which may increase the risk of childlessness in men affected by the disorder. Although this is an issue of significant clinical importance, it has not been addressed in research to date. We conducted a longitudinal cohort study based on data from Swedish national registers utilizing a large sample of help-seeking men with PD, along with matched subjects from the general population. We assessed the probability and odds ratio of childlessness, modeled with logistic regressions, and offspring rate ratio, modeled with Poisson regression. We found that the probability of childlessness was somewhat lowered for men with PD aged between 35 and 71 years at end of follow-up. Men with PD aged 35 or less showed slightly elevated probabilities of childlessness. Specifically, odds ratios for childlessness were between 0.5 and 1.0 for men aged above 35, and between 1 and 1.5 for men aged less than 35, although the confidence intervals for increased odds partly included the null. Analyses of men's rate of offspring showed similar pattern, with higher rate ratios for older men and lower for younger men. Although more research is needed, the findings of this study suggest that clinical urological practice may be enhanced by a proactive discussions about the potential issue of childlessness in younger men with PD.
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