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International Journal of Molecular... Jun 2023Peyronie's disease (PD) is a benign condition caused by plaque formation on the tunica albuginea of the penis. It is associated with penile pain, curvature, and... (Review)
Review
Peyronie's disease (PD) is a benign condition caused by plaque formation on the tunica albuginea of the penis. It is associated with penile pain, curvature, and shortening, and contributes to erectile dysfunction, which worsens patient quality of life. In recent years, research into understanding of the detailed mechanisms and risk factors involved in the development of PD has been increasing. In this review, the pathological mechanisms and several closely related signaling pathways, including TGF-β, WNT/β-catenin, Hedgehog, YAP/TAZ, MAPK, ROCK, and PI3K/AKT, are described. Findings regarding cross-talk among these pathways are then discussed to elucidate the complicated cascade behind tunica albuginea fibrosis. Finally, various risk factors including the genes involved in the development of PD are presented and their association with the disease summarized. The purpose of this review is to provide a better understanding regarding the involvement of risk factors in the molecular mechanisms associated with PD pathogenesis, as well as to provide insight into disease prevention and novel therapeutic interventions.
Topics: Male; Humans; Penile Induration; Phosphatidylinositol 3-Kinases; Quality of Life; Penis; Risk Factors
PubMed: 37373277
DOI: 10.3390/ijms241210133 -
European Urology Focus May 2020There is considerable interest in understanding the genetics of erectile dysfunction (ED) and Peyronie's disease (PD) in an effort to identify novel therapeutic and... (Review)
Review
There is considerable interest in understanding the genetics of erectile dysfunction (ED) and Peyronie's disease (PD) in an effort to identify novel therapeutic and preventative targets. Initial support for a genetic component of ED and PD was derived from familial aggregation studies. Candidate gene studies have suggested an association between polymorphisms of eNOS and ED and between TGF-β1 and PD. More recently, several genome-wide association studies have suggested an association between single-nucleotide polymorphisms of the SIM1 gene and ED. The development of models and functional assays that are able to explore these potential pathways implicated in ED and PD is pivotal for future studies. We highlight the current literature that supports a genetic component for ED and PD. PATIENT SUMMARY: There is great interest in understanding the genetic underpinnings of erectile dysfunction and Peyronie's disease. Candidate gene studies and genome-wide association studies have set a foundation for future work; however, we have yet to determine a true genetic cause. A better understanding of the genetics of these conditions will help advance novel therapeutics and preventative strategies.
Topics: Erectile Dysfunction; Humans; Male; Penile Induration
PubMed: 31474580
DOI: 10.1016/j.euf.2019.08.006 -
Andrology Feb 2023Peyronie's disease (PD) is a fibrosing disorder of the penis resulting in plaque formation and penile deformity that negatively affect sexual and psychosocial function... (Review)
Review
BACKGROUND
Peyronie's disease (PD) is a fibrosing disorder of the penis resulting in plaque formation and penile deformity that negatively affect sexual and psychosocial function of patients. A multifactorial etiology of PD is assumed with diabetes mellitus (DM) being a potential risk factor.
OBJECTIVES
The aim of this narrative review was to investigate diabetes role in PD pathophysiology, diagnosis, and treatment.
MATERIALS AND METHODS
A non-systematic narrative review of original articles, meta-analyses, and randomized trials was conducted, including articles in the pre-clinical setting to support relevant findings.
RESULTS
Diabetes is one of the most common comorbidity observed in PD patients, with a prevalence of about 11% and a strong association with erectile dysfunction (ED). DM is associated with both a higher risk of developing PD and has also an impact on the outcomes of PD's treatments.
DISCUSSION
Evidence from literature underlines that metabolic alterations typical of DM are pivotal factors in the development of PD and resistance to its medical treatment.
CONCLUSION
The role of DM in development of PD is still debated, while its role in PD development is not completely clear, there is a clear impact of DM on PD treatment outcomes.
Topics: Humans; Male; Diabetes Mellitus; Erectile Dysfunction; Penile Induration; Penis; Risk Factors; Meta-Analysis as Topic; Randomized Controlled Trials as Topic
PubMed: 35771713
DOI: 10.1111/andr.13224 -
Nature Reviews. Urology Mar 2019Peyronie's disease is not a rare disorder, and it can be devastating to the affected man. Although the gold-standard treatment of Peyronie's disease is surgery in the... (Review)
Review
Peyronie's disease is not a rare disorder, and it can be devastating to the affected man. Although the gold-standard treatment of Peyronie's disease is surgery in the stable phase, nonoperative management is preferred by some men and is the only treatment option in the acute phase of the disease, when surgery is contraindicated. No oral or topical therapy has been shown to be efficacious when administered alone, but some evidence supports their use as part of a combination therapy regimen. Intralesional therapies, particularly collagenase clostridium histolyticum (CCH), have shown promise. Mechanical therapies can provide benefit when applied for prolonged periods of time, improving penile curvature, indentation, and even restoring length. Regardless of the modality chosen, patient counselling is paramount, as recovery of the penis to its predisease state is highly unlikely. Thus, although many options exist for nonsurgical management of Peyronie's disease, surgery remains the best option for men who desire the most reliable and rapid pathway to a functionally straight, erect penis. The goal of nonsurgical therapy should be a scientifically feasible, safe approach to prevent the progression of, or reduce, deformity and improve sexual function.
Topics: Forecasting; Humans; Male; Penile Induration
PubMed: 30397330
DOI: 10.1038/s41585-018-0117-7 -
Urology Aug 2015
Topics: Diagnostic Self Evaluation; Humans; Male; Microbial Collagenase; Penile Induration; Surveys and Questionnaires
PubMed: 26199153
DOI: 10.1016/j.urology.2015.04.049 -
Current Urology Reports Sep 2016Peyronie's disease is a collagen wound healing disorder of the penis that negatively affects the quality of life of afflicted men. According to the 2015 AUA Consensus... (Review)
Review
Peyronie's disease is a collagen wound healing disorder of the penis that negatively affects the quality of life of afflicted men. According to the 2015 AUA Consensus Guidelines on Peyronie's Disease, minimally invasive intralesional therapies and surgical intervention form the basis of contemporary therapy for this disorder. These therapeutic options, along with selected portions of the guidelines, are explored in this review.
Topics: Calcium Channel Blockers; Humans; Interferon alpha-2; Interferon-alpha; Male; Microbial Collagenase; Penile Induration; Recombinant Proteins; Urologic Surgical Procedures, Male; Verapamil
PubMed: 27432377
DOI: 10.1007/s11934-016-0622-2 -
The Journal of Sexual Medicine Feb 2021Peyronie's disease (PD) is a challenging clinical entity. To assist clinicians with diagnosis and management, four separate organizations have published PD guidelines... (Review)
Review
BACKGROUND
Peyronie's disease (PD) is a challenging clinical entity. To assist clinicians with diagnosis and management, four separate organizations have published PD guidelines over the past five years, but there remains a lack of consensus and data-driven recommendations for many aspects of diagnosis and treatment.
AIM
To compare and contrast PD guidelines, highlighting key similarities and differences among the guideline panel recommendations and identify areas for further research.
METHODS
We performed an extensive review to compare and contrast diagnosis and treatment recommendations from publically available published PD guidelines from four different organizations: American Urological Association, European Association of Urology, Canadian Urologic Association, and the International Society of Sexual Medicine.
OUTCOMES
Key similarities and differences with regards to definition, evaluation, nonsurgical and surgical treatments were compared.
RESULTS
Points of general consensus among the guideline panels included: History is adequate for diagnosis of PD, and intracavernosal injection is a gold standard to evaluate penile deformity prior to invasive intervention. Careful counseling with shared decision-making is required prior to treatment. In general, plication and incision and/or grafting surgery is reserved for patients with preserved erectile function whereas penile prosthesis implantation is the only surgical option for PD patients with erectile dysfunction. Overall, nonsurgical treatments have inferior evidence of efficacy with these being the main area of controversy; however, all societies recognize that intralesional injections may be used. 0Further research into the pathophysiology of PD may direct novel treatments targeted towards early intervention and rigorous outcomes research may direct best practices for the surgical treatment of PD in the future.
CLINICAL IMPLICATIONS
PD is a challenging clinical entity. Direct comparison of the published PD guidelines highlights clear standards of care as well as areas where more research is needed to promote higher levels of evidence-based practice.
STRENGTHS & LIMITATIONS
To our knowledge this is the first report to directly compare and contrast published guidelines pertaining to the diagnosis and management of PD. Limitations include the lack of evidence-quality review pertaining to individual guideline recommendations, although this was not the aim of this review.
CONCLUSION
We highlight consensus of major urologic societies on many aspects of work up and management of PD with notable exceptions which may guide further research. Manka MG, White LA, Yafi FA, et al. Comparing and Contrasting Peyronie's Disease Guidelines: Points of Consensus and Deviation. J Sex Med 2021;18:363-375.
Topics: Canada; Consensus; Humans; Male; Penile Implantation; Penile Induration; Penis
PubMed: 33423972
DOI: 10.1016/j.jsxm.2020.11.013 -
Sexual Medicine Reviews Jun 2024Penile induration disease, commonly known as Peyronie's disease (PD), is a connective tissue disorder that affects the penis, leading to the development of fibrous... (Review)
Review
INTRODUCTION
Penile induration disease, commonly known as Peyronie's disease (PD), is a connective tissue disorder that affects the penis, leading to the development of fibrous plaques, penile curvature, and erectile dysfunction. PD is a common male reproductive system disease with a complex etiology involving multiple genes, signaling pathways, and different phenotypes.
OBJECTIVES
The etiology and pathogenesis of PD remain poorly understood, hindering the development of effective treatment strategies. By understanding the underlying mechanisms of PD, we can pave the way for targeted therapies and improved patient outcomes.
METHODS
We reviewed the epidemiology and pathophysiology of PD. We performed database searches on Google Scholar, PubMed, Medline, and Web of Science from inception to September 2023. The literature reviewed included priapism guidelines, review articles, current trial studies, and various literature related to PD.
RESULTS
This article provides a comprehensive overview of the current research progress on the disease, focusing on its genetic factors, signaling pathways, cellular mechanisms, phenotypic manifestations, and therapeutic targets. It can help identify individuals at higher risk, aid in early detection and intervention, and provide insights into fibrosis and tissue remodeling. It can also reveal potential therapeutic targets, guide accurate diagnoses and treatment strategies, and address the impact of the disease on patients' quality of life.
CONCLUSION
By integrating insights from genomics, molecular pathways, clinical phenotypes, and therapeutic potentials, our research aims to achieve a deeper and more comprehensive understanding of PD, propelling the field toward innovative strategies that enhance the lives of those affected by PD. The complex manifestations and pathogenesis of PD necessitate the use of multiple treatment methods for personalized care.
Topics: Humans; Penile Induration; Male; Phenotype; Genomics; Signal Transduction
PubMed: 38456235
DOI: 10.1093/sxmrev/qeae006 -
The Urologic Clinics of North America Aug 2022Surgical treatments for Peyronie's disease and erectile dysfunction are generally straightforward and associated with excellent outcomes. However, severe (>60°) and... (Review)
Review
Surgical treatments for Peyronie's disease and erectile dysfunction are generally straightforward and associated with excellent outcomes. However, severe (>60°) and multidirectional curvature, hourglass deformity, severe penile shortening, and ossified plaque may complicate surgery in patients with Peyronie's disease. Similarly, a history of priapism, prior implant infection, and penile injury can pose challenges to successful implant surgery secondary to severe corporal fibrosis. Thus, when these pathophysiological processes cause severe fibrosis and loss of function of the tunica albuginea and deep cavernosal spaces, adjunctive reconstructive techniques are necessary. Herein, we integrate the literature regarding surgical management of complex Peyronie's disease and erectile dysfunction with emphasis on plication, grafting, and implants to achieve satisfactory outcomes across the full range of etiology and degree of surgical complexity.
Topics: Erectile Dysfunction; Fibrosis; Humans; Male; Penile Induration; Penis; Plastic Surgery Procedures
PubMed: 35931434
DOI: 10.1016/j.ucl.2022.04.006 -
Urology Mar 2019
Topics: Humans; Male; Penile Induration
PubMed: 30597171
DOI: 10.1016/j.urology.2018.12.019