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Research and Reports in Urology 2016Peyronie's disease (PD) has significant effect on patients and their partners. We provide a current review of the epidemiology as well as the nonsurgical and surgical... (Review)
Review
INTRODUCTION
Peyronie's disease (PD) has significant effect on patients and their partners. We provide a current review of the epidemiology as well as the nonsurgical and surgical treatment of PD.
MATERIALS AND METHODS
Review of literature pertaining to PD with focus on epidemiology and treatment options.
CONCLUSION
PD is common and likely underreported. The availability of new and highly effective treatment options will catalyze patient awareness and subsequently the prevalence of disease.
PubMed: 27200305
DOI: 10.2147/RRU.S65620 -
Cureus Apr 2023Peyronie's disease is an acquired connective tissue disease of the tunica albuginea of the penis which usually presents with penile curvature/deformity and a palpable... (Review)
Review
Peyronie's disease is an acquired connective tissue disease of the tunica albuginea of the penis which usually presents with penile curvature/deformity and a palpable penile plaque. It is more common in Caucasian men over the fifth decade of life, but it is an under-reported disease. Conservative and non-surgical options are supported by limited evidence except for intralesional injection of collagenase clostridium histolyticum and have limited success. The improved outcome of surgical treatment is accompanied by the risk of erectile dysfunction. This is a brief overview of Peyronie's disease, its impact on the patient, and the available treatment options.
PubMed: 37143639
DOI: 10.7759/cureus.37037 -
Asian Journal of Urology Apr 2015Peyronie's disease (PD) is an acquired connective tissue disorder of the tunica albuginea of the corpus cavernosum, characterized by excessive fibrosis and plaque... (Review)
Review
Peyronie's disease (PD) is an acquired connective tissue disorder of the tunica albuginea of the corpus cavernosum, characterized by excessive fibrosis and plaque formation. PD can result in significant physical and psychological morbidity; as it may prevent intercourse and cause adverse impacts on partner relationships. The exact etiology and pathophysiology remain unclear, and many misconceptions about the disease associations, course and treatment exist. The disease has two distinct stages. The acute stage is characterized by pain, and disease may progress during this stage. Non-surgical managements at this stage aim to alleviate pain and stabilize the disease. Results for non-surgical treatment are often conflicting. The chronic stage occurs 6-12 months later, where pain disappears and the deformity stabilizes. Surgical treatment is reserved for significant deformity or with inability to penetrative intercourse. The choice of the surgical technique depends on the length of the penis, degree of deformity, erectile function, patients' expectations and surgeon's preference.
PubMed: 29264123
DOI: 10.1016/j.ajur.2015.04.019 -
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 Apr 2023Peyronie's disease has an impact on men's mental and physical health.
BACKGROUND
Peyronie's disease has an impact on men's mental and physical health.
AIM
We sought to translate the Peyronie's Disease Questionnaire into Danish, adapt it to the Danish cultural setting, and test it in a Danish population.
METHODS
Translation of the Peyronie's Disease Questionnaire was performed according to the guidelines for adapting health status measures for use in languages other than the source language by Beaton et al. The validated American Peyronie's Disease Questionnaire was developed to monitor patient symptoms after an intervention and to inspire a subsequent dialogue about physical and psychological symptoms with a healthcare provider, thereby allowing the patient and the healthcare professional to choose the best treatment. The expert committee agreed on a Danish version after cross-cultural adaptation. The Danish Peyronie's Disease Questionnaire was sent by electronic mail to a preselected group of 41 men with Peyronie's disease.
OUTCOMES
After completing the questionnaire, 32 men participated in a video interview regarding the questionnaire and were asked to identify any problematic fields or areas open to misunderstanding.
RESULTS
The Peyronie's Disease Questionnaire underwent major modifications in light of the comments of the first 10 respondents. Thereafter, only minor changes were made until data saturation was reached after 27 of the 32 respondents had been interviewed. In 87% of respondents Peyronie's disease bothered from the last time they had intercourse, and 93% of the men experienced being bothered by having intercourse less often. Peyronie's disease made 73% of respondents feel bodily discomfort, and 88% had intercourse less often than they used to have due to Peyronie's disease.
CLINICAL IMPLICATIONS
The Peyronie's Disease Questionnaire is a valuable tool in the crucial task of addressing Peyronie's disease, providing insight into the mental and sexual health problems as well as physical challenges faced by patients.
STRENGTHS AND LIMITATIONS
The interviewer's modest experience in conducting interviews is believed to have been duly compensated for by continuous and accumulating learning-while-doing process because the same interviewer conducted all of the interviews and did so consecutively.
CONCLUSIONS
Danish men expressed satisfaction with the questionnaire and found it valuable as a tool when visiting the doctor for the first time.
PubMed: 36970583
DOI: 10.1093/sexmed/qfac022 -
Translational Andrology and Urology Aug 2018Numerous treatments have been proposed for Peyronie's disease (PD). As the evidence base has expanded, the field of operative and non-operative options for patients has... (Review)
Review
Numerous treatments have been proposed for Peyronie's disease (PD). As the evidence base has expanded, the field of operative and non-operative options for patients has narrowed. Collagenase clostridium hystolyticum (CCH) injection now comprises the medical option, and surgical possibilities entail penile plication, plaque incision/excision and grafting, and prosthesis implantation. Still, questions abound regarding the optimal approach and indication for each of these treatments. We conducted a review of literature exploring the contemporary management of PD with a particular focus on work since the last American Urologic Association's (AUA) guidelines update for PD. Recent results and discussion indicate trends toward minimal invasiveness, toward a more holistic approach to the PD patient, and away from algorithmic management, galvanized, in part, by data challenging long-held beliefs.
PubMed: 30211050
DOI: 10.21037/tau.2018.04.06 -
Research and Reports in Urology 2023The clinical landscape of Peyronie's disease is everchanging. There has been growing interest in non-invasive therapeutic options that could assist patients with... (Review)
Review
The clinical landscape of Peyronie's disease is everchanging. There has been growing interest in non-invasive therapeutic options that could assist patients with achieving a meaningful reduction in penile curvature without surgical intervention. These therapies are wide-ranging in terms of their mechanisms of action, efficacies, and short- and long-term safety profiles. Recently, an abundance of outcomes literature on longstanding and novel non-surgical treatment modalities has been published. For sexual medicine providers hoping to offer patients the most up-to-date and evidence-based treatments for the management of Peyronie's disease, it can be challenging to gain a thorough understanding of this body of literature. In this clinical management review, the workup and current theories on the pathophysiology of Peyronie's disease are reviewed, and the most recent outcomes data on the currently available non-surgical treatment modalities are presented. With an accurate understanding of the current landscape of Peyronie's disease treatment, sexual health providers will be able to better evaluate and engage in evidence-based shared decision-making with their patients.
PubMed: 36756281
DOI: 10.2147/RRU.S278796 -
Frontiers in Pharmacology 2021Peyronie's disease (PD) is a localized fibrotic lesion of the penis that has adverse effects on men's health. In this review, we summarized the molecular mechanisms and... (Review)
Review
Peyronie's disease (PD) is a localized fibrotic lesion of the penis that has adverse effects on men's health. In this review, we summarized the molecular mechanisms and pharmacotherapies of PD. A literature search was conducted using PubMed and Cochrane Library during 2001-2020. Although no oral or topical medication demonstrated efficacy in monotherapy of PD, several intralesional medications have yielded promising results. Currently, the effective strategy in management of PD should be combined modality therapy, including but not limited to pharmacotherapy, mechanical therapy, and psychotherapy. Meanwhile, basic research is still necessary to facilitate the development of novel and more reliable treatments. In future, more attention should be given simultaneously to epigenetic changes, inflammatory cytokines, the abnormal wound-healing process, and profibrotic and anti-fibrotic factors to provide more options for this refractory disease.
PubMed: 34093182
DOI: 10.3389/fphar.2021.643641 -
Ultrasonography (Seoul, Korea) Jan 2018Penile Doppler ultrasonography is a high-performing, noninvasive or minimally-invasive imaging modality that allows the depiction of the normal anatomy and macroscopic... (Review)
Review
Penile Doppler ultrasonography is a high-performing, noninvasive or minimally-invasive imaging modality that allows the depiction of the normal anatomy and macroscopic pathologic changes in real time. Moreover, functional changes in penile blood flow, as seen in erectile dysfunction (ED), can be analyzed using color Doppler ultrasonography (CDUS). This review article describes the normal sonographic anatomy of the penis, the sonographic technique for evaluating ED, the normal phases of erection, and the various causes of ED. Additionally, we describe the interpretation of different parameters and findings on penile CDUS for the diagnosis and classification of ED, priapism, and Peyronie disease.
PubMed: 28736428
DOI: 10.14366/usg.17022 -
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