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The Canadian Journal of Urology Aug 2020Peyronie's disease is a common, benign condition characterized by an acquired penile abnormality due to fibrosis of the tunica albuginea. This may lead to penile... (Review)
Review
INTRODUCTION
Peyronie's disease is a common, benign condition characterized by an acquired penile abnormality due to fibrosis of the tunica albuginea. This may lead to penile curvature, deformity, discomfort, pain, and erectile dysfunction, resulting in emotional and psychosocial effects on patients. Therefore, it is important for urologists to thoroughly evaluate the extent of the patient's bother and discuss treatment goals, therapeutic options, and expectations.
MATERIALS AND METHODS
We provide a review of the current landscape for the diagnosis, management, and treatment of Peyronie's disease, including oral, topical, intralesional, external energy, and surgical therapies.
RESULTS
The hallmark of managing Peyronie's disease is attentive patient counseling. Patients may be hesitant to discuss their symptoms unless inquired directly and may not be aware that treatments exist. It is not uncommon for Peyronie's disease to be diagnosed incidentally during a routine or unrelated healthcare visit, with reported rates of incidental diagnosis as high as 16%. Treatment options are stratified by disease phase which is defined by whether symptoms (e.g. penile deformity and discomfort) are actively changing or have stabilized. Conservative therapy is the most common recommendation during the active phase with more invasive treatments reserved for the passive phase. Conservative therapy may include oral or topical medication, intralesional injection, and external energy therapy. These treatments may also have a role in improving symptoms during the passive phase prior to undergoing more definitive surgical treatment. Surgical interventions include tunical plication, plaque incision or excision with or without grafting, and penile prosthesis implantation. Despite the variety of treatment options available to patients, each has a distinct efficacy and adverse effect profile, warranting thorough discussion to meet patients' goals and manage expectations.
CONCLUSION
Peyronie's disease is a common condition that is underdiagnosed and undertreated. Patients with Peyronie's disease will benefit from a comprehensive evaluation and in-depth counseling so that they may become familiar with the natural disease course and have appropriate expectations of each treatment option.
Topics: Humans; Male; Penile Induration
PubMed: 32875997
DOI: No ID Found -
International Journal of Impotence... May 2022Penile concerns include erectile dysfunction (ED) and Peyronie disease (PD). Restorative therapies including Stem Cell Therapy (SCT) and Platelet Rich Plasma (PRP)... (Review)
Review
Penile concerns include erectile dysfunction (ED) and Peyronie disease (PD). Restorative therapies including Stem Cell Therapy (SCT) and Platelet Rich Plasma (PRP) injections are proposed to treat these concerns. SCT encompasses the harvesting and injection of mesenchymal stem cells or stromal vascular fractions from various tissue sources. PRP is derived autologously from a patient's plasma and is then injected into the penile tissue. These therapies repair damaged penile tissue and promote both new cellular and vascular growth, as demonstrated in basic science studies. Human trials on SCT and PRP for both ED and PD and have yielded promising results with few side effects. While encouraging, small cohort size and lack of blinding or placebo control limit these studies' external validity. Recently, the first double-blinded randomized controlled trial on PRP for ED was published, providing significant evidence of efficacy. With the rapid commercial availability of SCT and PRP for ED and PD, it is imperative to perform more randomized and placebo-controlled trials with standardized procedures and preparations to evaluate efficacy and safety. This narrative review will summarize the available literature on these penile restorative therapies to date.
Topics: Erectile Dysfunction; Humans; Male; Penile Induration; Penis; Platelet-Rich Plasma; Rejuvenation; Stem Cell Transplantation
PubMed: 34743193
DOI: 10.1038/s41443-021-00482-z -
Deutsches Arzteblatt International Sep 2018The incidence of penile cancer in Europe lies in the range of 0.9 to 2.1 cases per 100 000 persons per year. Carcinogenesis is associated with human papilloma virus...
BACKGROUND
The incidence of penile cancer in Europe lies in the range of 0.9 to 2.1 cases per 100 000 persons per year. Carcinogenesis is associated with human papilloma virus (HPV) infection and with chronic inflammation.
METHODS
This review is based on publications (2010-2017) retrieved by a selective search in PubMed and EMBASE and on the guidelines of the European Association of Urology, the European Society of Medical Oncology, the National Comprehensive Cancer Network, and the National Institute for Health and Care Excellence (NICE).
RESULTS
95% of cases of penile cancer are accounted for by squamous cell carcinoma, whose numerous subtypes have different clinical courses. Chronic preputial inflammation due to phimosis or lichen sclerosus is often associated with penile cancer. Circumcision lowers the risk of penile cancer (hazard ratio: 0.33). Maximally organ-preserving surgery with safety margins of no more than a few millimeters is the current therapeutic standard, because a local recurrence, if it arises, can still be treated locally with curative intent. Local radiotherapy can be performed in early stages. Lymphogenic metastasis must be treated with radical lymphadenectomy and adjuvant chemotherapy. Patients with clinically unremarkable inguinal lymph nodes nonetheless need invasive lymph node staging because of the high rate of lymphogenic micrometastasis.
CONCLUSION
Penile cancer is curable in all early stages with the appropriate treatment, but its prognosis depends crucially on the proper management of the regional (i.e., inguinal) lymph nodes. In many countries, the treatment of this rare disease entity has been centralized.
Topics: Carcinoma, Squamous Cell; Europe; Humans; Lymph Nodes; Male; Neoplasm Metastasis; Penile Neoplasms
PubMed: 30375327
DOI: 10.3238/arztebl.2018.0646 -
Sexual Medicine Reviews Jan 2021Although the literature of the positive effects of penile low intensity extracorporeal shockwave therapy is meanwhile substantial, there are substantial differences... (Review)
Review
Review of the Current Status of Low Intensity Extracorporeal Shockwave Therapy (Li-ESWT) in Erectile Dysfunction (ED), Peyronie's Disease (PD), and Sexual Rehabilitation After Radical Prostatectomy With Special Focus on Technical Aspects of the Different Marketed ESWT Devices Including Personal...
INTRODUCTION
Although the literature of the positive effects of penile low intensity extracorporeal shockwave therapy is meanwhile substantial, there are substantial differences regarding both the sources of energies and extracorporeal shockwave therapy (ESWT) devices.
OBJECTIVES
To provide an overview on the energy range and energy differences of the 6 currently marketed ESWT devices along with personal ESWT experiences in 350 patients.
METHODS
This review includes all published preclinical and clinical penile ESWT studies with evaluation of the technical differences of the 6 ESWT devices and the personal experiences with these 6 devices in ED and PD. The main outcomes measures were success rates in ED (International Index of Erectile Function-erectile function change, conversion of phosphodiesterase type 5 inhibitors non-responders) and PD (change in deviation and plaque size), differences of used sources of energy, and energy flux densities (EFDs).
RESULTS
3 different sources of energies are used, that is electromagnetic, electrohydraulic, and piezoelectric .The devices markedly distinguish in the available spectrum of the EFD ranging between 0.09 and 0.55 mJ/mm². In terms of the biological effects, the relevant energy parameters are -6 dB and the 5 MPa focus, which differ substantially between the ESWT devices. In addition, a great variability in the treatment protocols and applied energy is obvious. The preliminary own experiences with low intensity extracorporeal shockwave therapy in 160 ED non-responders and 190 patients with PD with success rates of 45% and 47%, respectively, are reported.
CONCLUSION
Positive results were published with all 6 ESWT devices in question in patients with organic ED but with huge differences regarding the EFD and the total energies applied. There is growing evidence that concentrated treatment protocols and increasing energies may yield better results. In this context, it may be argued that at least some of the published studies were markedly underpowered .Owing to the paucity of published studies, the literature of the effects of ESWT in PD and for penile rehabilitation after pelvic surgery is currently not conclusive. Porst H. Review of the Current Status of Low Intensity Extracorporeal Shockwave Therapy (Li-ESWT) in Erectile Dysfunction (ED), Peyronie's Disease (PD), and Sexual Rehabilitation After Radical Prostatectomy With Special Focus on Technical Aspects of the Different Marketed ESWT Devices Including Personal Experiences in 350 Patients. Sex Med 2021;9:93-122.
Topics: Erectile Dysfunction; Extracorporeal Shockwave Therapy; Humans; Male; Penile Induration; Penis; Prostatectomy
PubMed: 32499189
DOI: 10.1016/j.sxmr.2020.01.006 -
Tidsskrift For Den Norske Laegeforening... Nov 2023Balanoposthitis is an inflammation of the glans penis and/or prepuce. It is a common condition with diverse aetiology. A targeted medical history and clinical...
Balanoposthitis is an inflammation of the glans penis and/or prepuce. It is a common condition with diverse aetiology. A targeted medical history and clinical examination are needed for correct diagnosis and treatment. This clinical review is a summary of the diagnostic process and treatment of balanoposthitis. The work is based on a selection of clinical guidelines and literature, as well as clinical experience from a dermatovenereology outpatient clinic.
Topics: Male; Humans; Balanitis; Penis; Inflammation; Ambulatory Care Facilities; Physical Examination
PubMed: 37938014
DOI: 10.4045/tidsskr.23.0256 -
Internal Medicine (Tokyo, Japan) Sep 2018Mondor's disease (MD) is a rare disease that manifests with a palpable cord-like induration on the body surface. In general, MD is a self-limited, benign... (Review)
Review
Mondor's disease (MD) is a rare disease that manifests with a palpable cord-like induration on the body surface. In general, MD is a self-limited, benign thrombophlebitis that resolves in four to eight weeks without any specific treatment. Cases of MD can be roughly categorized into three different groups based on the site of the lesion as follows: original MD of the anterolateral thoracoabdominal wall, penile MD with dorsum and dorsolateral aspects of the penis, and axillary web syndrome with mid-upper arm after axillary surgery. The diagnosis of MD is rather straightforward and based on a physical examinations. However, some case occur "secondary" with another underlying disease, including malignancy, a hypercoagulative state, and vasculitis. Therefore, it is critical to identify MD precisely, evaluate any possible underlying disease, and avoid any unnecessary invasive tests or treatment. In this paper, we comprehensively review the clinical characteristics of MD.
Topics: Arm; Humans; Male; Penile Diseases; Rare Diseases; Thrombophlebitis
PubMed: 29780120
DOI: 10.2169/internalmedicine.0495-17 -
Urologic Oncology Jan 2020Recent advances in cancer research have highlighted the role of genetics in malignancy. Genetic dysregulation of core cellular functions similarly influences benign... (Review)
Review
INTRODUCTION
Recent advances in cancer research have highlighted the role of genetics in malignancy. Genetic dysregulation of core cellular functions similarly influences benign conditions. These common genetic factors have led researchers to identify an association between certain urologic conditions and malignancy. The objective of this review is to evaluate the literature linking benign urologic conditions including male infertility, Peyronie's disease, cryptorchidism, and hypospadias, to malignancy.
METHODS
A search of PubMed was performed using the following search terms and their combinations: male infertility, female infertility, cancer, malignancy, mortality, male urologic conditions, azoospermia, Peyronie's disease, cryptorchidism, hypospadias, and genetics. Studies were assessed for quality and included or excluded based on study design and relevance to the topic of urologic conditions and malignancy.
RESULTS
A total of 52 studies were evaluated, of which 38 were included. Associations between male infertility and testicular cancer, prostate cancer, and other cancers including melanoma, bladder cancer, and thyroid cancer were examined. Several genetic alterations were found to be common in the pathogenesis of both male infertility and carcinogenesis. Associations between female infertility and breast, ovarian, and endometrial cancer are also assessed, as are the relationships between Peyronie's disease, cryptorchidism, and hypospadias and malignancy.
CONCLUSIONS
Recent work has identified associations between a number of malignancies and benign urologic conditions including male infertility, Peyronie's disease, cryptorchidism, and hypospadias. Molecular and genetic mechanisms have been proposed, but no definitive causal relationships have been identified to date. Future work will continue to better define the links between malignancy and benign urologic conditions and ultimately facilitate risk stratification, screening, and treatment of affected men.
Topics: Humans; Infertility, Male; Male; Penile Induration; Risk Factors; Testicular Neoplasms; Urologic Diseases; Urologic Neoplasms
PubMed: 30611645
DOI: 10.1016/j.urolonc.2018.12.018 -
The Pan African Medical Journal 2022
Topics: Calciphylaxis; Humans; Male; Penile Diseases; Penis
PubMed: 35480413
DOI: 10.11604/pamj.2022.41.124.33602 -
Ugeskrift For Laeger Feb 2018Deviation of the penis may be congenital or acquired. The latter, also known as Peyronie's disease, is seen in 0.4-9% of patients. The aetiology is not fully understood,... (Review)
Review
Deviation of the penis may be congenital or acquired. The latter, also known as Peyronie's disease, is seen in 0.4-9% of patients. The aetiology is not fully understood, but the hypothesis is that microtrauma leads to scar tissue formation, plaques, which deform the penis. The disease is divided into a first, painful, progressive, inflammatory phase and a latter, steady, chronic phase. The symptoms are mainly sexual dysfunction and psychological problems. Surgery is recommended in congenital cases and in the chronic phase of Peyronie's disease, where the medical treatment has not been convincing.
Topics: Algorithms; Humans; Male; Penile Induration; Penis
PubMed: 29493499
DOI: No ID Found -
Minerva Urologica E Nefrologica = the... Dec 2018Penile cancer is a rare disease. Most of penile cancer are squamous cell carcinoma. Diagnosis is based on self-examination, clinical examination and confirmatory biopsy.... (Review)
Review
Penile cancer is a rare disease. Most of penile cancer are squamous cell carcinoma. Diagnosis is based on self-examination, clinical examination and confirmatory biopsy. Several imaging techniques could be used for staging purposes. However, the best modality for staging in intermediate and high-risk patients is by surgical evaluation and the use of inguinal lymph node dissection, that has also a therapeutic effect. Unfortunately, inguinal lymph node dissection is underused. Penile cancer treatment may have a major adverse impact on urinary and sexual function and on quality of life. Penile-sparing surgery and radiation therapies are available, and in selected patients offer good outcomes with acceptable rates of local recurrence. Penile-sparing surgery should be preferred when indicated. Follow-up with periodical controls is mandatory up to 5 years. However, risk of local, nodal and distant recurrence after 5 years was reported. Imaging is not routinely recommended during follow-up. Patients should be trained to self-examination during the follow-up.
Topics: Humans; Male; Penile Neoplasms
PubMed: 30230297
DOI: 10.23736/S0393-2249.18.03215-0