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Aktuelle Urologie Aug 2020
Topics: Humans; Male; Penile Induration; Penis; Traction
PubMed: 32726844
DOI: 10.1055/a-1019-5652 -
The Journal of Sexual Medicine Mar 2023Priapism, a urologic emergency, has known associations with certain medical conditions. Many cases are idiopathic, suggesting an opportunity to identify novel risk...
BACKGROUND
Priapism, a urologic emergency, has known associations with certain medical conditions. Many cases are idiopathic, suggesting an opportunity to identify novel risk factors.
AIM
We sought to identify medical conditions and pharmaceutical treatments that are associated with priapism using data-mining techniques.
METHODS
Using deidentified data in a large insurance claims database, we identified all men (age ≥20 years) with a diagnosis of priapism from 2003 to 2020 and matched them to cohorts of men with other diseases of male genitalia: erectile dysfunction, Peyronie disease, and premature ejaculation. All medical diagnoses and prescriptions used prior to first disease diagnosis were examined. Predictors were selected by random forest, and conditional multivariate logistic regressions were applied to assess the risks of each predictor.
OUTCOMES
We identified novel relationships of HIV and some HIV treatments with priapism and confirmed existing associations.
RESULTS
An overall 10 459 men with priapism were identified and matched 1:1 to the 3 control groups. After multivariable adjustment, men with priapism had high associations of hereditary anemias (odds ratio [OR], 3.99; 95% CI, 2.73-5.82), use of vasodilating agents (OR, 2.45; 95% CI, 2.01-2.98), use of HIV medications (OR, 1.95; 95% CI, 1.36-2.79), and use of antipsychotic medications (OR, 1.90; 95% CI, 1.52-2.38) as compared with erectile dysfunction controls. Similar patterns were noted when compared with premature ejaculation and Peyronie disease controls.
CLINICAL IMPLICATIONS
HIV and its treatment are associated with priapism, which may affect patient counseling.
STRENGTHS AND LIMITATIONS
To our knowledge, this is the first study to identify risk factors for priapism utilizing machine learning. All men in our series were commercially insured, which limits the generalizability of our findings.
CONCLUSION
Using data-mining techniques, we confirmed existing associations with priapism (eg, hemolytic anemias, antipsychotics) and identified novel relationships (eg, HIV disease and treatment).
Topics: Male; Humans; Young Adult; Adult; Priapism; Erectile Dysfunction; Premature Ejaculation; Penile Induration; HIV Infections; Anemia
PubMed: 36881738
DOI: 10.1093/jsxmed/qdad017 -
Archivos Espanoles de Urologia Oct 2022Platelet rich plasma is a product obtained from vein whole blood sample, with a high concentration of growth factors, which have been reported to be beneficial for... (Review)
Review
INTRODUCTION
Platelet rich plasma is a product obtained from vein whole blood sample, with a high concentration of growth factors, which have been reported to be beneficial for tissue regeneration. In the last few years, several assays that pretend to demonstrate the efficacy of platelet rich plasma in many disciplines, including urology, have been published.
AIM AND METHODS
The aim of this assay is to develop a bibliographic review of the publications available about platelet rich plasma and urology. The search was based on PubMed database.
CONCLUSIONS
Platelet rich plasma has demonstrated to be a safe and easy to obtain product, and it has also shown promising results in terms of efficacy in urology. However, it is necessary to conduct large, placebo-controlled, studies that can confirm or deny the effectiveness of platelet rich plasma before it can be used on urological conditions.
Topics: Humans; Urology; Platelet-Rich Plasma; Urologic Diseases
PubMed: 36330568
DOI: 10.56434/j.arch.esp.urol.20227508.98 -
Andrology Oct 2022Peyronie's disease (PD) has previously been observed to co-aggregate in a small number of first-degree relative pairs (e.g., father-son). However, the familial...
BACKGROUND
Peyronie's disease (PD) has previously been observed to co-aggregate in a small number of first-degree relative pairs (e.g., father-son). However, the familial aggregation of PD in more distant relatives, as well as the aggregation of Dupuytren's disease (DD) in probands and relatives, has not been thoroughly investigated.
OBJECTIVE
This study explored the evidence for familial clustering of PD and DD in close and distant relatives.
MATERIALS AND METHODS
The Utah Population Database, which includes genealogy information linked to electronic medical records (available since 1995), was used to identify men and their relatives with PD and DD based on ICD9/10 codes. All cases were required to have high-quality genealogy data. We estimated relative risk (RR) of PD and DD in first- through fifth-degree relatives compared to matched population rates of disease. We also investigated the average relatedness of cases compared to the average relatedness of sets of matched controls. Outcome measures include estimation of relative risk and excessive relatedness as measured by a Genealogical Index of Familiality (GIF) analysis.
RESULTS
We analyzed 307 individuals with PD, and their first- through fifth-degree relatives. Approximately 0.12% of the population had PD, 95% of these were diagnosed over the age of 30 years (age range: 10-92 years), and 1.3% of PD probands had a comorbid diagnosis of DD. RR estimates for PD were significant for first- and fifth-degree relatives. RR estimates for DD were significant only for probands. The average relatedness of cases was significantly greater than matched controls, even after removing first- and second-degree relatives. We also found that 74.9% of identified PD probands belonged to pedigrees with a statistical excess of PD.
CONCLUSION
Despite the low prevalence of PD in our healthcare records, the results provide evidence that support a genetic contribution to at least a subset of PD cases.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Cluster Analysis; Comorbidity; Genetic Predisposition to Disease; Humans; Male; Middle Aged; Pedigree; Penile Induration; Risk; Risk Factors; Young Adult
PubMed: 35770847
DOI: 10.1111/andr.13223 -
The World Journal of Men's Health Jan 2024To investigate the efficacy of medical treatment options for Peyronie's disease (PD) including oral drugs, intralesional treatment and mechanical treatment compared with...
PURPOSE
To investigate the efficacy of medical treatment options for Peyronie's disease (PD) including oral drugs, intralesional treatment and mechanical treatment compared with placebo treatment using network meta-analysis (NMA).
MATERIALS AND METHODS
We searched the randomized controlled trials (RCTs) of PD in PubMed, Cochrane library, and EMBASE up to October 2022. RCTs included medical treatment options: oral drugs, intralesional treatment and mechanical treatment. Studies reporting at least one of the outcome measures of interest including curvature degree, plaque size, and structured questionnaires (International Index of Erectile Function, IIEF) were included.
RESULTS
Finally, 24 studies including 1,643 participants met our selection criteria for NMA. There was no statistically significant treatment compared to placebo of the curvature degree, plaque size, IIEF in Bayesian analysis. The SUCRA values of ranking probabilities for each treatment performance, which indicated that hyperthermia device ranked first in NMA. However, in frequentist analysis, 7 of mono treatments (coenzyme Q10 [CoQ10] 300 mg, hyperthermia device, interferon alpha 2b, pentoxifylline 400 mg, propionyl-L-carnitine 1 g, penile traction therapy [PTT], vitamin E 300 mg) and 2 of combination treatments ("PTT-extracorporeal shockwave treatment", "vitamin E 300 mg-propionyl-L-carnitine 1 g") were statistically significant for improvement of curvature degree, and 9 of mono treatments (CoQ10 300 mg, hyaluronic acid 16 mg, hyperthermia device, interferon alpha 2b, pentoxifylline 400 mg, propionyl-L-carnitine 1 g, verapamil 10 mg, vitamin E 300 mg, vitamin E 400 U) and 3 of combination treatments ("interferon alpha 2b-vitamin E 400 U", "verapamil 10 mg-antioxidants", "vitamin E 300 mg-propionyl-L-carnitine 1 g") were statistically significant in the improvement of plaque size.
CONCLUSIONS
At present, there is no clinical treatment alternatives that have been demonstrated to be effective compared to placebo. Nonetheless, as the frequentist approach has shown that a number of agents are efficacious, further research is expected to develop more effective treatment options.
PubMed: 37382281
DOI: 10.5534/wjmh.230016 -
International Journal of Impotence... Jan 2020To date, surgical correction remains the gold standard for patients with stable Peyronie's disease (PD) due to its high efficacy and low morbidity. Among the surgical... (Review)
Review
To date, surgical correction remains the gold standard for patients with stable Peyronie's disease (PD) due to its high efficacy and low morbidity. Among the surgical procedures, penile plication (PP) can be offered to men who have adequate erectile function and penile length (>13 cm), with a curvature <60° and a predicted shortening of maximum 20% of the penis. The aim of this paper is to review the new developments that have emerged in the last years about the use of PP in patients with PD. A nonsystematic review of the literature was carried out searching in the PubMed and EMBASE databases from January 01, 2009 to April 01, 2019 including the words 'Peyronie', 'penile curvature', 'penile induration', 'plication', and 'plicature'. New developments in PP in the last 10 years include avoiding degloving by using a penoscrotal incision, a new mathematical model to predict loss of length after PP, a wider range of indications including patients with severe (≥60°) or complex curvatures, burying knots to avoid later discomfort, and thinning or incising the plaque to prevent excessive shortening. PP is a well-founded procedure with great results in appropriately selected patients. Given the lack of any prospective randomized trial, no clear recommendation can be made of one technique over another.
Topics: Erectile Dysfunction; Humans; Male; Penile Erection; Penile Induration; Penis; Suture Techniques; Sutures; Treatment Outcome; Urologic Surgical Procedures, Male
PubMed: 31582822
DOI: 10.1038/s41443-019-0204-1 -
The Urologic Clinics of North America Feb 2022Over the past decade, there have been several advancements in the technologies available to treatment erectile dysfunction and Peyronie's disease. Vacuum erection... (Review)
Review
Over the past decade, there have been several advancements in the technologies available to treatment erectile dysfunction and Peyronie's disease. Vacuum erection devices, penile traction devices, low-intensity extracorporeal shockwave therapy, and penile prosthesis surgery have evolved and are changing the way we treat men's health. Although significant improvements have been made, further work is needed to standardize treatment, create universal algorithms for technological applications, and simply their use.
Topics: Combined Modality Therapy; Erectile Dysfunction; Extracorporeal Shockwave Therapy; Humans; Male; Microbial Collagenase; Penile Implantation; Penile Induration; Penile Prosthesis; Traction; Vacuum
PubMed: 34776050
DOI: 10.1016/j.ucl.2021.07.013 -
Sexual Medicine Reviews Apr 2021Peyronie's disease (PD) is an acquired wound-healing disorder of the penis involving fibrosis and scar formation within the tunica albuginea that can lead to various... (Review)
Review
INTRODUCTION
Peyronie's disease (PD) is an acquired wound-healing disorder of the penis involving fibrosis and scar formation within the tunica albuginea that can lead to various penile deformities resulting in penile pain, sexual dysfunction, low self-esteem, and emotional distress. While many studies highlight the psychosocial impact of PD on the patient, little is known about the female partner's experience regarding PD and its management.
OBJECTIVES
To evaluate and summarize the available clinical data on the effects of the disease and its management on female sexual partners of patients with PD.
METHODS
A search of the available medical literature using the MEDLINE and PubMed databases was performed. The queried terms included the following: Peyronie's disease, partner, female, dyspareunia, relationship, satisfaction, survey, and outcome. Studies were included only if the female sexual partners were directly evaluated or interviewed.
RESULTS
PD can have a significant impact on the sexual function and satisfaction of female sexual partners. Most female sexual partners reported an improvement in their relationship, a decrease in sexual dysfunction, and improved overall satisfaction after both surgical and nonsurgical treatment.
CONCLUSION
PD can be emotionally debilitating for patients and their partners. It has been associated with depression, social stigmatization, isolation, diminished self-worth, and avoidance of intimacy. A partner's experience with PD, as well as its management and outcomes, is an understudied entity that warrants further investigation and may be useful in guiding future treatment approaches. Kern T, Ye N, Abdelsayed GA. Peyronie's Disease: What About the Female Sexual Partner?. Sex Med Rev 2021;9:230-235.
Topics: Female; Humans; Male; Penile Induration; Penis; Sexual Behavior; Sexual Dysfunction, Physiological; Sexual Partners
PubMed: 33341426
DOI: 10.1016/j.sxmr.2020.11.002 -
BMC Urology Sep 2023The therapeutic role of extracorporeal shockwave therapy (ESWT) for Peyronie's disease (PD) has been controversial in a long term. We aimed to further evaluate the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The therapeutic role of extracorporeal shockwave therapy (ESWT) for Peyronie's disease (PD) has been controversial in a long term. We aimed to further evaluate the therapeutic effect of ESWT for PD on the basis of available high-quality studies.
METHODS
The PubMed, CENTRAL and Embase databases were searched for articles published from January 1st, 2000 to December 31, 2022. Only randomized controlled trials (RCTs) using ESWT to treat PD were included. Meta-analysis and forest plots were carried out using Review Manager 5.4.1 software, and outcomes were reviewed by 2 authors independently. Using the Risk of Bias assessment form (ROB-2) by Cochrane Collaboration for quality assessment. PRISMA 2020 guidelines were used in this article to achieve the quantitative and qualitative synthesis of data.
RESULTS
A total of four RCTs were included. 151 patients in the ESWT group and 150 patients in the control group. The meta-analysis results showed that ESWT could significantly reduce plaque size (OR 2.59, 95%CI 1.15 to 5.85, P = 0.02) and relieve pain (MD -1.55, 95%CI -2.46 to -0.64, P = 0.0008); but it has no significant effect on reducing the penile curvature (OR 1.93, 95%CI 0.87-4.26, P = 0.11) and improving sexual function (MD 2.6, 95%CI -1.63 to 6.83, P = 0.23), there is also no significant difference in complication rates between groups (OR 2.94, 95%CI 0.66 to 13.03, P = 0.16). The risk of bias of results is low. The limitations of this study are that the number of included studies is too small, some experimental outcomes are missing, and the expression of outcomes is not unified.
CONCLUSIONS
For PD, ESWT can be considered as a safe short-term treatment, which can reduce plaque size and relieve pain, but cannot improve penile curvature and sexual function. Its long-term efficacy remains to be discussed.
REGISTRATION NUMBER
PROSPERO (ID: CRD42023436744).
Topics: Male; Humans; Penile Induration; Extracorporeal Shockwave Therapy; Penis; Databases, Factual; Pain
PubMed: 37700253
DOI: 10.1186/s12894-023-01320-8 -
Progres En Urologie : Journal de... Oct 2022Platelet-rich plasma (PRP) injections are increasingly proposed for the treatment of Peyronie's disease since the discontinuation of Xiapex® despite poorly understood...
INTRODUCTION
Platelet-rich plasma (PRP) injections are increasingly proposed for the treatment of Peyronie's disease since the discontinuation of Xiapex® despite poorly understood results.
OBJECTIVES
Evaluation of the tolerance and efficacy of intra-plate PRP injections in patients with Peyronie's disease.
METHODS
Three intra-plate injections of PRP were performed 15 days apart in 17 patients with Peyronie's disease. The Peyronie's Disease Questionnaire (PDQ) and the measurement of the angle of curvature of the erect penis were assessed before treatment and then 1, 3 and 6 months after treatment. Erectile function was assessed by different questionnaires (IIEF-EF, EHS, SEP, sexual discomfort score).
RESULTS
No side effects were noted during the study period. Three months after treatment, all three PDQ domains were significantly improved (P=0.002; P=0.015; P=0.017 respectively). The angle of curvature of the penis was significantly decreased by 11.8° with a mean angle of 40.4° before treatment and 28.6° after (P=0.007). The IIEF-EF score was significantly improved after treatment (mean preoperative value: 10.67) with a gain of 5 points at months 1 and 6 (P=0.01 and P=0.036 respectively) and 7 points at month 3 (P=0.04).
CONCLUSION
Our initial experience suggests that PRP injections for Peyronie's disease are safe. Although the limited data is suggestive of efficacy, a placebo control will be required for confirmation.
Topics: Humans; Male; Penile Induration; Penis; Pilot Projects; Platelet-Rich Plasma; Treatment Outcome
PubMed: 35778315
DOI: 10.1016/j.purol.2022.05.004