Prevalence of penile curvature: a population-based cross-sectional study in metropolitan and rural cities in Australia.

OBJECTIVE: To evaluate the prevalence of penile curvature and health-seeking behaviour in Australian men. PATIENTS AND METHODS: A population-based, cross-sectional anonymous web-based survey was designed, and men aged between 35 and 75 years in major and rural metropolitan cities across Australia were invited to participate. Respondents were screened for self-reported symptoms of penile curvature and their impact on various psychosexual domains. RESULTS: Of a total of 1782 men who responded, 333 men (19%) reported a bend or curve in their penis and completed the main section of the questionnaire to address the impact of penile curvature on various psychosexual domains. A third of men with penile curvature (32%) reported penile curvature of ≥ 30°, with approximately equal proportions among the three age groups (33% in those aged 35-49 years, 37% in those aged 50-64 years, and 30% in those aged 65-75 years) and with no significant difference detected in the penile curvature characteristics between men in major metropolitan and those in rural cities across Australia. One in six men reported an adverse impact of penile curvature in their lives, complaining of penile pain or discomfort when they had an erection, while 26% of men were bothered by the appearance of their penis and 20% were bothered when they tried to have sexual intercourse. Men aged 35-49 years were more likely than those aged 65-75 years to be bothered by the penile curvature (31% vs 18%; P < 0.05) and men in the age group 65-75 years were twice as likely to have trouble with sexual intercourse compared with other age groups (39% vs 18%; P < 0.05). CONCLUSIONS: This first population-based study to estimate the prevalence of penile curvature in Australia highlighted that penile curvature is common and has a significant adverse impact on psychosexual functions.

Dysphagia as a risk factor for mortality in Niemann-Pick disease type C: systematic literature review and evidence from studies with miglustat.

Niemann-Pick disease type C (NP-C) is a rare neurovisceral disease characterised by progressive neurological deterioration and premature death, and has an estimated birth incidence of 1:120,000. Mutations in the NPC1 gene (in 95% of cases) and the NPC2 gene (in approximately 4% of cases) give rise to impaired intracellular lipid metabolism in a number of tissues, including the brain. Typical neurological manifestations include vertical supranuclear gaze palsy, saccadic eye movement abnormalities, cerebellar ataxia, dystonia, dysmetria, dysphagia and dysarthria. Oropharyngeal dysphagia can be particularly problematic as it can often lead to food or fluid aspiration and subsequent pneumonia. Epidemiological data suggest that bronchopneumonia subsequent to food or fluid aspiration is a major cause of mortality in NP-C and other neurodegenerative disorders. These findings indicate that a therapy capable of improving or stabilising swallowing function might reduce the risk of aspiration pneumonia, and could have a positive impact on patient survival. Miglustat, currently the only approved disease-specific therapy for NP-C in children and adults, has been shown to stabilise key neurological manifestations in NP-C, including dysphagia. In this article we present findings from a systematic literature review of published data on bronchopneumonia/aspiration pneumonia as a cause of death, and on the occurrence of dysphagia in NP-C and other neurodegenerative diseases. We then examine the potential links between dysphagia, aspiration, pneumonia and mortality with a view to assessing the possible effect of miglustat on patient lifespan.