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International Journal of Impotence... Apr 2024
Response to the Commentary on "Intermediate-term results of TachoSil grafting to correct residual curvature during inflatable penile prosthesis implantation in patients with Peyronie's disease".
PubMed: 38653802
DOI: 10.1038/s41443-024-00896-5 -
Sexual Medicine Reviews Jun 2024Peyronie's disease (PD) is a common penile disorder characterized by the formation of fibrous noncompliant hard nodules in the tunica albuginea of the penis. Collagenase... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Peyronie's disease (PD) is a common penile disorder characterized by the formation of fibrous noncompliant hard nodules in the tunica albuginea of the penis. Collagenase Clostridium histolyticum (CCH) is an injectable drug that treats PD by enzymatically degrading plaque interstitial collagen. CCH has been used in patients with varying curvature, as well as in the acute and stable phases of the disease, through a variety of treatment regimens and combinations. We carried out a systematic review and meta-analysis to assess the efficacy of CCH combination therapies for PD.
METHODS
We selected 4 observational comparative studies and 3 randomized controlled trials including 532 participants from the PubMed, Embase, and Cochrane databases (until December 2023) to evaluate the efficacy of CCH combination therapies for PD. The primary outcome was clinical efficacy as evaluated by improvement in penile curvature and penile length, as well as by scores on the Peyronie's Disease Questionnaire (PDQ) for symptom bother, penile pain, and psychological symptoms. Continuous data were represented by mean difference (MD) and 95% CI. All data were analyzed by Review Manager version 5.3.
RESULTS
For penile length (MD, 0.81 cm; 95% CI, 0.17-1.45; P = .01), PDQ symptom bother (MD, -1.02; 95% CI, -1.83 to -0.21; P = .01), and PDQ penile pain (MD, -0.93; 95% CI, -1.50 to -0.36; P = .001), CCH combination therapy showed significantly greater improvements vs CCH monotherapy. However, in the other indicators, penile curvature and PDQ psychological symptoms, there was no significant difference between the therapies.
CONCLUSION
This meta-analysis supports that CCH combination therapies can partially increase penile length and ameliorate symptom bother and penile pain to some extent. However, CCH combination therapies still need to be evaluated through more high-quality research.
Topics: Penile Induration; Humans; Male; Microbial Collagenase; Drug Therapy, Combination; Treatment Outcome; Penis
PubMed: 38650382
DOI: 10.1093/sxmrev/qeae025 -
The French Journal of Urology Jun 2024With 50 years' experience, inflatable penile implants are the preferred option for erectile dysfunction refractory to pharmacological and mechanical treatment. Technical... (Review)
Review
INTRODUCTION
With 50 years' experience, inflatable penile implants are the preferred option for erectile dysfunction refractory to pharmacological and mechanical treatment. Technical and surgical improvements have optimized patient success and satisfaction. However, multi-factorial dissatisfaction persists.
OBJECTIVE
The aim of this study is to provide an overview of available technological improvements and innovations, as well as the perioperative management and complications of inflatable penile implant surgery.
METHOD
A literature review was carried out over the last twenty years to answer 4 questions: what are the different inflatable penile implants available in 2023, for which indications, results and complications.
RESULTS
Four companies propose inflatable penile implants in France. The main improvements have been in the various components of the prosthesis with better cylinder extension, more ergonomic reservoirs, and more manageable pumps, leading to a better durability. Indications have been extended to patients suffering from Peyronie's disease and in emergency cases of priapism. In response to demand from the transgender population, specific phalloplasty implants have been developed. New options are being developed for difficult cases of retracted penis. Results show a high satisfaction rate. Currently the main challenge is the management of infection with the development of rescue protocols using antibiotics to preserve implants - or replace them in a single operation.
CONCLUSION
After 50years' experience, improvements in penile implants led to effective, satisfactory and safe treatment and can be proposed in new indications. Further development is sill necessary to offer solutions in difficult cases.
Topics: Humans; Penile Prosthesis; Male; France; Erectile Dysfunction; Prosthesis Design; Penile Implantation; History, 20th Century; History, 21st Century; Patient Satisfaction
PubMed: 38599322
DOI: 10.1016/j.fjurol.2024.102635 -
Zhonghua Nan Ke Xue = National Journal... Apr 2023Penis cavernosa fibrosis is an important cause of refractory erectile dysfunction.Its exact pathogenesis remains incompletely elucidated, and conventional treatment is... (Review)
Review
Penis cavernosa fibrosis is an important cause of refractory erectile dysfunction.Its exact pathogenesis remains incompletely elucidated, and conventional treatment is not effective, seriously affecting the quality of life, physical and mental health of men. With the deepening of research, the progress of two-dimensional shear wave elastography (2D-SWE) and molecular imaging provides the possibility for the early diagnosis, grading and staging of cavernous fibrosis. Studies on stem cell therapy, energy-based treatments, targeted therapy, and traditional Chinese medicine show promising applications in the anti-penile cavernous fibrosis. This article reviews the research progress in the diagnosis and treatment of penile cavernosis fibrosis.
Topics: Male; Humans; Quality of Life; Elasticity Imaging Techniques; Medicine, Chinese Traditional; Mental Health; Penile Induration; Penis
PubMed: 38598222
DOI: No ID Found -
International Journal of Impotence... May 2024
Response to the Commentary on: Safety and feasibility of percutaneous needle tunneling with platelet-rich plasma injections for Peyronie's disease in the outpatient setting: a pilot study.
PubMed: 38580726
DOI: 10.1038/s41443-024-00874-x -
Journal of Visualized Experiments : JoVE Mar 2024Peyronie's Disease (PD) is clinically characterized by the development of localized fibrous plaques, primarily on the tunica albuginea, especially on the dorsal area of...
Peyronie's Disease (PD) is clinically characterized by the development of localized fibrous plaques, primarily on the tunica albuginea, especially on the dorsal area of the penis. These plaques are the hallmark feature of this condition, resulting in penile curvature, deformity, and painful erections for affected individuals. Although various nonsurgical treatment options exist, their overall effectiveness is limited. As a result, surgical intervention has become the ultimate choice for patients with severe penile curvature deformities and associated erectile dysfunction. Our research team has successfully employed a combined approach involving microscopic electric rotary grinding of the fibrous plaques and the use of tunica vaginalis or bovine pericardium as graft materials for the repairing of the defects of tunica albuginea in the treatment of PD. This approach has consistently yielded highly satisfactory results regarding the restoration of penile shape, with excellent cosmetic results and significantly improved sexual satisfaction. This protocol aims to present a comprehensive surgical management strategy utilizing electric rotary grinding of the plaques and repairing the defects of tunica albuginea by using the tunica vaginalis, which represents an optimal surgical strategy for treating PD.
Topics: Male; Humans; Animals; Cattle; Penile Induration; Penis; Erectile Dysfunction; Fibrosis; Plaque, Amyloid; Plaque, Atherosclerotic
PubMed: 38557978
DOI: 10.3791/66305 -
Diagnostics (Basel, Switzerland) Mar 2024Elastography is a noninvasive method that utilizes ultrasound imaging to assess the elasticity and stiffness of soft tissue. Peyronie's disease (PD) is a chronic... (Review)
Review
Elastography is a noninvasive method that utilizes ultrasound imaging to assess the elasticity and stiffness of soft tissue. Peyronie's disease (PD) is a chronic inflammatory condition that affects the male penis, causing the formation of fibrous plaques. This alters the penis's elasticity and can lead to changes in its shape. Ultrasound elastography (UE) is an important advancement in the diagnosis of PD. It not only identifies plaques, but it also measures their rigidity, providing crucial information to monitor changes during and after treatment. We conducted a narrative review of the scientific literature to identify articles that discuss the use of elastography in the diagnostic study of PD. The purpose of this study was to describe the "state of the art" in the diagnostic use of ultrasound in combination with elastography to highlight any benefits in the diagnosis of PD. We found 12 relevant articles after searching PubMed, Embase, and Google Scholar using the keywords "ultrasound elastography" and "Peyronie's disease", including eight clinical studies, two case reports, and two review articles. The results of our review indicate that UE is a useful technique for identifying Peyronie-related plaques, particularly when they are not detectable using a standard ultrasound or physical examination. It is also helpful in monitoring improvements during and after conservative treatments. More research is required to confirm the effectiveness of ultrasound elastography in diagnosing Peyronie's disease and to determine whether it is better than traditional ultrasound.
PubMed: 38535085
DOI: 10.3390/diagnostics14060665 -
BioDrugs : Clinical Immunotherapeutics,... May 2024Erectile dysfunction (ED) is a common clinical condition that mainly affects men aged over 40 years. Various causes contribute to the progression of ED, including pelvic... (Review)
Review
Erectile dysfunction (ED) is a common clinical condition that mainly affects men aged over 40 years. Various causes contribute to the progression of ED, including pelvic nerve injury, diabetes, metabolic syndrome, age, Peyronie's disease, smoking, and psychological disorders. Current treatments for ED are limited to symptom relief and do not address the root cause. Stem cells, with their powerful ability to proliferate and differentiate, are a promising approach for the treatment of male ED and are gradually gaining widespread attention. Current uses for treating ED have been studied primarily in experimental animals, with most studies observing improvements in erectile quality as well as improvements in erectile tissue. However, research on stem cell therapy for human ED is still limited. This article summarizes the recent literature on basic stem cell research on ED, including cavernous nerve injury, aging, diabetes, and sclerosing penile disease, and describes mechanisms of action and therapeutic effects of various stem cell therapies in experimental animals. Stem cells are also believed to interact with host tissue in a paracrine manner, and improved function can be supported through both implantation and paracrine factors. To date, stem cells have shown some preliminary promising results in animal and human models of ED.
Topics: Humans; Erectile Dysfunction; Male; Stem Cell Transplantation; Animals; Stem Cells
PubMed: 38520608
DOI: 10.1007/s40259-024-00650-9 -
International Journal of Impotence... May 2024
Response to: "Commentary on: phosphodiesterase type 5 inhibitors do not prevent curvature progression but shorten pain duration in the active phase of Peyronie's disease: a retrospective cohort study".
PubMed: 38519589
DOI: 10.1038/s41443-024-00872-z -
International Journal of Impotence... May 2024
Commentary on "Intermediate-term results of TachoSil grafting to correct residual curvature during inflatable penile prosthesis implantation in patients with Peyronie's disease.".
PubMed: 38509347
DOI: 10.1038/s41443-024-00858-x