Urol. praxi. 2021;22(3):143-147 | DOI: 10.36290/uro.2020.056

Peyronie's disease - today's treatment options

MUDr. David Čapka1, 2, MUDr. Robert Grill1
1 Urologická klinika 3. LF UK v Praze a FNKV, Praha
2 Andrologická klinika, Praha

Peyronie's disease, or plastic penile induration (IPP), is a very unpleasant disease that causes patients a lot of hardship and is far from rare. It often occurs in older men with the typical age of onset of difficulty 50-60, but it also occurs in younger men. The aetiology is not exactly known, but a local autoimmune disease is assumed. The article discusses risk factors, the course and treatment of the disease. The treatment is divided into conservative, with intra - and surgical treatments having the most promising results. Intralesional therapy may reduce the indication of surgery or change the technique to be performed, but only after full instruction by the patient. The decision on the most appropriate surgery to correct penile curvature is based on pre-operative evaluation of penile length, degree of curvature and status of erectile dysfunction (ED). If there is concomitant ED that does not respond to pharmacological treatment, implantation of a penile prosthesis, with or without straightening the penis, is the best option.

Keywords: Peyronie's disease, plastic penile induration, penile deviation, penile angulation, erectile disfunction.

Received: December 23, 2020; Revised: December 23, 2020; Accepted: December 23, 2020; Prepublished online: December 23, 2020; Published: October 21, 2021  Show citation

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Čapka D, Grill R. Peyronie's disease - today's treatment options. Urol. praxi. 2021;22(3):143-147. doi: 10.36290/uro.2020.056.
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References

  1. Chung E, et al. Prevalence of penile curvature: a population-based cross-sectional study in metropolitan and rural cities in Australia. BJU Int 2018; 122: 42. Go to original source... Go to PubMed...
  2. Arafa M, et al. The prevalence of Peyronie's disease in diabetic patients with erectile dysfunction. Int J Impot Res 2007; 19: 213. Go to original source... Go to PubMed...
  3. Stuntz M, et al. The Prevalence of Peyronie's Disease in the United States: A Population-Based Study. PLoS One 2016; 11: e0150157. Go to original source... Go to PubMed...
  4. Levine LA, et al. Peyronie disease in younger men: characteristics and treatment results. J Androl 2003; 24: 27. Go to original source... Go to PubMed...
  5. Devine CJ, Jr, et al. Proposal: trauma as the cause of the Peyronie's lesion. J Urol 1997; 157: 285. Go to original source... Go to PubMed...
  6. Gonzalez-Cadavid NF, et al. Mechanisms of Disease: new insights into the cellular and molecular pathology of Peyronie's disease. Nat Clin Pract Urol 2005; 2: 291. Go to original source... Go to PubMed...
  7. Herati AS, et al. The Genetic Basis of Peyronie Disease: A Review. Sex Med Rev 2016; 4: 85. Go to original source... Go to PubMed...
  8. Kadioglu A, et al. A retrospective review of 307 men with Peyronie's disease. J Urol 2002; 168: 1075. Go to original source... Go to PubMed...
  9. Ventimiglia E, et al. Peyronie's disease and autoimmunity-a real-life clinical study and comprehensive review. J Sex Med 2015; 12: 1062. Go to original source... Go to PubMed...
  10. Cavallini G, et al. Association between Peyronie disease and low serum testosterone levels: detection and therapeutic considerations. J Androl 2012; 33: 381. Go to original source... Go to PubMed...
  11. Shindel AW, et al. Prevalence of Peyronie's Disease-Like Symptoms in Men Presenting With Dupuytren Contractures. Sex Med 2017; 5: e135. Go to original source... Go to PubMed...
  12. Kadioglu A, et al. A retrospective review of 307 men with Peyronie's disease. J Urol, 2002; 168: 1075. Go to original source... Go to PubMed...
  13. Pryor JP, et al. Clinical presentations of Peyronie's disease. Int J Impot Res 2002; 14: 414. Go to original source... Go to PubMed...
  14. Mulhall JP, et al. An analysis of the natural history of Peyronie's disease. J Urol 2006; 175: 2115. Go to original source... Go to PubMed...
  15. Nelson CJ, et al. The chronology of depression and distress in men with Peyronie's disease. J Sex Med, 2008; 5: 1985. Go to original source... Go to PubMed...
  16. Hellstrom WJ, et al. Bother and distress associated with Peyronie's disease: validation of the Peyronie's disease questionnaire. J Urol 2013; 190: 627. Go to original source... Go to PubMed...
  17. Masterson TA, et al. Characteristics predictive of response to collagenase clostridium histolyticum for Peyronie's disease: a review of the literature. World J Urol 2020; 38(2): 279-285. Go to original source... Go to PubMed...
  18. Liguori G, et al. Objective measurements of the penile angulation are significantly different than self-estimated magnitude among patients with penile curvature. Int Braz J Urol 2018; 44: 555. Go to original source... Go to PubMed...
  19. Habous M, et al. Outcomes of variation in technique and variation in accuracy of measurement in penile length measurement. Int J Impot Res 2018; 30: 21. Go to original source... Go to PubMed...
  20. Hauck EW, et al. Diagnostic value of magnetic resonance imaging in Peyronie's disease--a comparison both with palpation and ultrasound in the evaluation of plaque formation. Eur Urol 2003; 43: 293. Go to original source... Go to PubMed...
  21. Dean RC, et al. Physiology of penile erection and pathophysiology of erectile dysfunction. Urol Clin North Am, 2005; 32: 379. Go to original source... Go to PubMed...
  22. Kadioglu A, et al. Color Doppler ultrasound assessment of penile vascular system in men with Peyronie's disease. Int J Impot Res 2000; 12: 263. Go to original source... Go to PubMed...
  23. Zámečník L. Neinvazivní nechirurgická léčba plastické indurace penisu. Urol. praxi 2015; 16(1): 21-24.
  24. Chung E, et al. Evidence-Based Management Guidelines on Peyronie's Disease. J Sex Med 2016; 13: 905. Go to original source... Go to PubMed...
  25. Muller A, et al. Peyronie's disease intervention trials: methodological challenges and issues. J Sex Med, 2009; 6: 848. Go to original source... Go to PubMed...
  26. Nehra A, et al. Peyronie's Disease: AUA Guideline. J Urol 2015; 194: 745. Go to original source... Go to PubMed...
  27. Safarinejad MR, et al. Retraction statement: A double-blind placebo-controlled study of the efficacy and safety of pentoxifylline in early chronic Peyronie's disease. BJU Int 2015; 115: E10. Go to original source... Go to PubMed...
  28. Ferrini MG, et al. Effects of long-term vardenafil treatment on the development of fibrotic plaques in a rat model of Peyronie's disease. BJU Int 2006; 97: 625. Go to original source... Go to PubMed...
  29. Chung E, et al. The role of PDE5 inhibitors in penile septal scar remodeling: assessment of clinical and radiological outcomes. J Sex Med 2011; 8: 1472. Go to original source... Go to PubMed...
  30. Ozturk U, et al. Effects of sildenafil treatment on patients with Peyronie's disease and erectile dysfunction. Ir J Med Sci 2014;. 183: 449. Go to original source... Go to PubMed...
  31. Mulhall JP, et al. Peyronie's disease cell culture models: phenotypic, genotypic and functional analyses. Int J Impot Res 2002; 14: 397. Go to original source... Go to PubMed...
  32. Favilla V, et al. Evaluation of intralesional injection of hyaluronic acid compared with verapamil in Peyronie's disease: preliminary results from a prospective, double-blinded, randomized study. Andrology 2017; 5: 771. Go to original source... Go to PubMed...
  33. Toscano L, Jr, et al. A prospective, randomized, single - blind study comparing intraplaque injection of thiocolchicine and verapamil in Peyronie's Disease: a pilot study. Int Braz J Urol 2016; 42: 1005. Go to original source... Go to PubMed...
  34. Jordan GH. The use of intralesional clostridial collagenase injection therapy for Peyronie's disease: a prospective, single-center, non-placebo-controlled study. J Sex Med 2008; 5: 180. Go to original source... Go to PubMed...
  35. EMA, Assessement Report - Xiapex (Collagenase Clostridium Histolyticum). 2014.
  36. Russo GI, et al. Comparative Effectiveness of Intralesional Therapy for Peyronie's Disease in Controlled Clinical Studies: A Systematic Review and Network Meta-Analysis. J Sex Med 2019; 16: 289. Go to original source... Go to PubMed...
  37. Lipshultz LI, et al. Clinical efficacy of collagenase Clostridium histolyticum in the treatment of Peyronie's disease by subgroup: results from two large, double-blind, randomized, placebo-controlled, phase III studies. BJU Int 2015; 116: 650. Go to original source... Go to PubMed...
  38. Carson CC 3rd, et al. Analysis of the clinical safety of intralesional injection of collagenase Clostridium histolyticum (CCH) for adults with Peyronie's disease (PD). BJU Int 2015; 116: 815. Go to original source... Go to PubMed...
  39. Liguori G, et al. Objective measurements of the penile angulation are significantly different than self-estimated magnitude among patients with penile curvature. Int Braz J Urol 2018; 44: 555. Go to original source... Go to PubMed...
  40. Abdel Raheem A, et al. Safety and effectiveness of collagenase clostridium histolyticum in the treatment of Peyronie's disease using a new modified shortened protocol. BJU Int 2017; 120: 717. Go to original source... Go to PubMed...
  41. Nguyen HMT, et al. Safety and Efficacy of Collagenase Clostridium histolyticum in the Treatment of Acute-Phase Peyronie's Disease. J Sex Med 2017; 14: 1220. Go to original source... Go to PubMed...
  42. Bittner L, Zámečník L, Turčan P. Aplikace klostridiové kolagenázy je metodou volby v neoperační léčbě Peyronieho choroby. 2016. Konference: 62. výroční konference České urologické společnosti ČLS JEP, České Budějovice, 19. 10. 2016-21. 10. 2016.
  43. Duncan MR, et al. Regulation of the proliferation and biosynthetic activities of cultured human Peyronie's disease fibroblasts by interferons-alpha, -beta and -gamma. Scand J Urol Nephrol 1991; 25: 89. Go to original source... Go to PubMed...
  44. Stewart CA, et al. Intralesional Injection of Interferon-alpha2b Improves Penile Curvature in Men with Peyronie's Disease Independent of Plaque Location. J Urol, 2015; 194: 1704. Go to original source... Go to PubMed...
  45. Munoz-Rangel CA, et al. Minimally Invasive Therapy Using Intralesional OnabotulinumtoxinA in Peyronie's Disease. Urol J 2015; 12: 2105. Go to PubMed...
  46. Montorsi F, et al. Transdermal electromotive multi-drug administration for Peyronie's disease: preliminary results. J Androl 2000; 21: 85. Go to original source... Go to PubMed...
  47. Twidwell J, et al. Topical treatment for acute phase Peyronie's disease utilizing a new gel, H-100: a randomized, prospective, placebo-controlled pilot study. Int J Impot Res, 2016; 28: 41. Go to original source... Go to PubMed...
  48. Muller A, et al. Peyronie's disease intervention trials: methodological challenges and issues. J Sex Med 2009; 6: 848. Go to original source... Go to PubMed...
  49. Liu T, et al. Cellular signaling pathways modulated by low-intensity extracorporeal shock wave therapy. Int J Impot Res 2019; 31: 170. Go to original source... Go to PubMed...
  50. Bittner L. Mechanické rehabilitační pomůcky v andrologii. Konference: 13. zimní urologické symposium, Špindlerův Mlýn, 15. 01. 2017-19. 01. 2017.
  51. Chung E, et al. Peyronie's disease and mechanotransduction: an in vitro analysis of the cellular changes to Peyronie's disease in a cell-culture strain system. J Sex Med 2013; 10: 1259. Go to original source... Go to PubMed...
  52. Moncada I, et al. Penile traction therapy with the new device 'Penimaster PRO' is effective and safe in the stable phase of Peyronie's disease: a controlled multicentre study. BJU Int 2019; 123: 694. Go to original source... Go to PubMed...
  53. Broderick GA, et al. The hemodynamics of vacuum constriction erections: assessment by color Doppler ultrasound. J Urol 1992; 147: 57. Go to original source... Go to PubMed...
  54. Paulis G, et al. Long-term multimodal therapy (verapamil associated with propolis, blueberry, vitamin E and local diclofenac) on patients with Peyronie's disease (chronic inflammation of the tunica albuginea). Results of a controlled study. Inflamm Allergy Drug Targets, 2013; 12: 403. Go to original source... Go to PubMed...
  55. Avant RA, et al. Penile Traction Therapy and Vacuum Erection Devices in Peyronie's Disease. Sex Med Rev, 2019; 7: 338. Go to original source... Go to PubMed...
  56. Ziegelmann MJ, et al. Clinical Experience With Penile Traction Therapy Among Men Undergoing Collagenase Clostridium histolyticum for Peyronie Disease. Urology 2017; 104: 102. Go to original source... Go to PubMed...
  57. Haney NM, et al. The Effect of Adjunct Mechanical Traction on Penile Length in Men Undergoing Primary Treatment for Peyronie's Disease: A Systematic Review and Meta-analysis. Urology 2018; 122: 110. Go to original source... Go to PubMed...
  58. Chung E, et al. Evidence-Based Management Guidelines on Peyronie's Disease. J Sex Med 2016; 13: 905. Go to original source... Go to PubMed...
  59. Kadioglu A, et al. Current status of the surgical management of Peyronie's disease. Nat Rev Urol 2011; 8: 95. Go to original source... Go to PubMed...
  60. Matsushita K, et al. Concordance between patient and physician assessment of the magnitude of Peyronie's disease curvature. J Sex Med 2014; 11: 205. Go to original source... Go to PubMed...
  61. Zaid UB, et al. Surgical management of Peyronie's disease. Current urology reports 2014; 15: 446. Go to original source... Go to PubMed...
  62. Rolle L, et al. The Nesbit operation for penile curvature: an easy and effective technical modification. J Urol, 2005; 173: 171. Go to original source... Go to PubMed...
  63. Reddy RS, et al. Plication for Severe Peyronie's Deformities Has Similar Long-Term Outcomes to Milder Cases. J Sex Med 2018; 15: 1498. Go to original source... Go to PubMed...
  64. Gelbard MK, et al. The natural history of Peyronie's disease. J Urol 1990; 144: 1376. Go to original source... Go to PubMed...
  65. Rybak J, et al. A retrospective comparative study of traction therapy vs. no traction following tunica albuginea plication or partial excision and grafting for Peyronie's disease: measured lengths and patient perceptions. J Sex Med 2012; 9: 2396. Go to original source... Go to PubMed...
  66. Bittner L, Zámečník L. "Prodlužovací" inflatabilní implantát je preferovaným modelem při implantaci penilní protézy. Ces Urol 2019; 23(4): 59. ISSN 1211-8729. Konference: 65. výroční konference České urologické společnosti ČLS JEP, Praha, 16. 10.-18. 10. 2019.
  67. Bittner L, Zámečník L. Implantace penilní protézy jako léčba Peyronieho choroby spojené s erektilní dysfunkcí. 2018. Konference: 64. výroční konference České urologické společnosti ČLS JEP, Ostrava, 17. 10.-19. 10. 2018.
  68. Levine LA, et al. Penile Prosthesis Surgery: Current Recommendations From the International Consultation on Sexual Medicine. J Sex Med 2016; 13: 489. Go to original source... Go to PubMed...
  69. Wilson SK, et al. A new treatment for Peyronie's disease: modeling the penis over an inflatable penile prosthesis. J Urol 1994; 152: 1121. Go to original source... Go to PubMed...
  70. Egydio PH, et al. The Multiple-Slit Technique (MUST) for Penile Length and Girth Restoration. J Sex Med 2018; 15: 261. Go to original source... Go to PubMed...
  71. Khera M, et al. Penile Prosthesis Implantation in Patients With Peyronie's Disease: Results of the PROPPER Study Demonstrates a Decrease in Patient-Reported Depression. J Sex Med 2018; 15: 786. Go to original source... Go to PubMed...




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