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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 -
Sexual Medicine Dec 2020Providers may use several treatment options for patients with Peyronie's disease; however, it is unclear whether practice patterns have evolved over recent years and if...
INTRODUCTION
Providers may use several treatment options for patients with Peyronie's disease; however, it is unclear whether practice patterns have evolved over recent years and if this has impacted cost.
AIMS
To investigate trends in the treatment of Peyronie's disease over time and the associated costs using a national, commercial insurance claims database.
METHODS
A retrospective cohort study was conducted using claims from the Truven MarketScan database from 2007 to 2018 for men with Peyronie's disease. Cost was estimated as either the sum of prescription oral or injectable treatment costs or as the single net cost associated with the operative procedure.
MAIN OUTCOME MEASURES
Frequency of use of various treatments for Peyronie's disease and associated costs were assessed as trends over the timeline by year.
RESULTS
The estimated annual incidence of Peyronie's disease in this population rose from 61 to 77 per 100,000 patients over the included years, and the percent annual treatment rate rose from 17.8% to 26.2%. Colchicine was the most commonly prescribed oral agent in 2007 used in 22% of treated individuals; by 2018, pentoxifylline was the most common prescribed oral agent used in 33%. In 2007, 11% of treated patients received intralesional verapamil; however, by 2018, 24% received injectable collagenase, whereas <1% received intralesional verapamil. The mean annual, per-individual cost of Peyronie's disease treatment increased from $1,531 in 2007 to $10,339 in 2018. The cost increase was greatest for injectable therapies, which rose from $811 per individual in 2007 to $16,184 in 2018, a 19-fold increase.
CONCLUSIONS
Diagnosis and treatment of Peyronie's disease is increasing over time. Pentoxifylline has become the most common oral prescription, whereas injectable collagenase has become most common injection. The mean cost associated with Peyronie's disease treatment increased more than 5 times from 2007 to 2018 corresponding with Federal Drug Administration's approval of injectable collagenase. Loftus CJ, Rajanahally S, Holt SK, et al. Treatment Trends and Cost Associated With Peyronie's Disease. Sex Med 2020;8:673-678.
PubMed: 33036960
DOI: 10.1016/j.esxm.2020.08.003 -
Urologia Internationalis 2007Peyronie's disease (PD) is characterized by the onset of fibrous plaque inside the tunica albuginea of the penile corpora cavernosa that can cause pain and bending... (Review)
Review
Peyronie's disease (PD) is characterized by the onset of fibrous plaque inside the tunica albuginea of the penile corpora cavernosa that can cause pain and bending during the erection, making intercourse difficult or impossible. Evidence of the literature supports the autoimmune etiology of PD and suggests genetic and familiar conditions, penile traumatisms, and a history of genital tract diseases as risk factors, but no definitive conclusions arise about the pathogenesis of the disease. Few randomized trials demonstrated that medical therapies, such as vitamin E, colchicine, potassium aminobenzoate, tamoxifen, and injection therapy with verapamil, can stabilize the acute phase of the disease. Extracorporeal shock wave therapy and iontophoresis cannot be considered first-line or gold standard therapies. Satisfactory results have been published with the Nesbit operation in large series with low-stage disease, whereas plication procedures have shown significant relapse rates. A high incidence of long-term penile retractions has been reported in high-stage disease treated with plaque incision and simple graft insertion. Malleable, soft, or inflatable prostheses combined with graft implantation have given the best results in terms of penile straightening and lengthening and patient satisfaction. In conclusion, the etiopathogenesis of PD is not yet clearly understood, no medical therapy is fully effective, and surgery remains the gold standard in patients with severe deformity and/or erectile dysfunction.
Topics: Antineoplastic Agents; High-Energy Shock Waves; Humans; Iontophoresis; Magnetic Resonance Imaging; Male; Penile Induration; Prognosis; Tubulin Modulators; Ultrasonography, Doppler; Urologic Surgical Procedures, Male
PubMed: 17192725
DOI: 10.1159/000096927 -
International Braz J Urol : Official... 2016
Topics: Evidence-Based Medicine; Humans; Male; Penile Induration; Practice Guidelines as Topic
PubMed: 27813380
DOI: 10.1590/S1677-5538.IBJU.2016.06.02 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2021This review article focuses on conservative treatment options, topical, intralesional therapy, traction and vacuum therapy. A PubMed database search was performed for... (Review)
Review
This review article focuses on conservative treatment options, topical, intralesional therapy, traction and vacuum therapy. A PubMed database search was performed for studies that were published between 1948 and 2019. Search keywords included "Peyronie's disease," "conservative therapy," "traction treatment," "extracorporeal shock wave therapy," "topical and oral therapies," and "vaccum therapy." Clinical trials in men with Peyronie's disease and scientific articles relating to pharmacologic data were included in the review. When possible, large, randomized, and well-designed trials were selected. Non-English-language articles were excluded.
Topics: Conservative Treatment; Extracorporeal Shockwave Therapy; Humans; Male; Penile Induration
PubMed: 33813465
DOI: No ID Found -
Frontiers in Reproductive Health 2022Peyronie's disease is the disease that results in an alteration in the curvature of the penis, which can lead to a shortening of length, pain in erection, or... (Review)
Review
INTRODUCTION
Peyronie's disease is the disease that results in an alteration in the curvature of the penis, which can lead to a shortening of length, pain in erection, or difficulties in penetration, thus leading the patient to psychological alterations due to loss of functionality such as aesthetic alteration. That is why there are several studies to define the best form of treatment, which currently continues to be the first choice surgical treatment.
OBJECTIVE
We present the most recommended therapies for Peyronie's disease and suggest an algorithm as a guide to direct therapy.
METHODS
We used the PubMed platform to review the literature related to Peyronie's disease. Various editorials were reviewed as well as original articles and reviews focusing on the various treatments as well as their indications and results.
RESULTS
Peyronie's disease in which conservative or drug treatment does not have a response, surgical treatment with corporoplasty, penile prosthesis implantation or both may be indicated. Corporoplasty refers to both the plication of the tunica albuginea as well as the incision of the tunica with the placement of a graft. An accurate history should always be carried out to identify erectile dysfunction as well as to be able to guide you on the repercussions of the treatment. If refractory erectile dysfunction is present, placement of a penile prosthesis with or without further adjunctive straightening maneuvers is recommended. We reviewed the indications, advantages, disadvantages, and results of the available techniques, and proposed a surgical treatment algorithm.
CONCLUSION
Penile shortening procedures are usually indicated in curvatures <60°, in penises with adequate length. Partial excision/incision and grafting are indicated for curvatures >60°, hourglass or hinge deformities, and short penises, if the patient's erectile function is adequate. The presence of "borderline" erectile function and/or ventral curvature tilts the choice toward shortening procedures, and refractory erectile dysfunction is an indication for penile prosthesis placement. An accurate risk/benefit assessment of the individual patient as well as meticulous patient counseling are critically important.
PubMed: 36303674
DOI: 10.3389/frph.2022.863844 -
Andrology Jan 2018The difficulty implicit in combining all the characteristics that an ideal patch to treat Peyronie's disease with a lengthening procedure should have, together with the... (Review)
Review
The difficulty implicit in combining all the characteristics that an ideal patch to treat Peyronie's disease with a lengthening procedure should have, together with the challenges of comparing results from different series, means that the ideal patch has yet to be determined. Our objective with this review was to determine whether any given patch type is preferable to the others based on the evaluation of the results of published studies. A systematic search of the literature was conducted from PubMed until December 2016. Articles reporting basic research, animal research, reviews or meta-analyses and studies in children were eliminated. Series with patients undergoing some kind of other surgical intervention were only included if results were reported separately. Case reports and series of five patients were excluded. Five variables were selected to evaluate the results: number of patients, follow-up period, straightening rate, shortening rate and post-operative ED rate. For this purpose, 69 papers were included for review, and the outcomes of the use of autologous dermis, tunica vaginalis, dura mater, fascia, saphenous vein, tunica albuginea, buccal mucosa, porcine intestinal submucosa, pericardium, TachoSil and synthetic materials were presented and analysed separately. The different series published are extremely variable and heterogeneous in terms of the number of patients included, patient selection, follow-up periods, and in the measurement and interpretation of the outcomes analysed. Given these facts, it is not possible to draw any definitive conclusion, homogeneous, prospective studies using validated tools are required to determine which the ideal graft is.
Topics: Animals; Heterografts; Humans; Male; Penile Induration; Transplants; Urologic Surgical Procedures, Male
PubMed: 29266877
DOI: 10.1111/andr.12421 -
Arab Journal of Urology 2021: To review the literature on adult penile reconstruction due to Peyronie's disease, trauma and cosmesis, while emphasising specific surgical techniques and procedures... (Review)
Review
OBJECTIVE
: To review the literature on adult penile reconstruction due to Peyronie's disease, trauma and cosmesis, while emphasising specific surgical techniques and procedures such as phalloplasty, radial forearm free flap reconstruction, and penile transplant.
METHODS
: A comprehensive review of the literature for the years 1992-2020 of the PubMed and SpringerLink databases was performed to identify articles on penile reconstruction. Search terms included 'penile reconstruction', 'penile trauma', 'phalloplasty', 'penile transplant', and 'treatment of Peyronie's'. Relevant articles were selected. All included studies were performed on adults and written in English.
RESULTS
: We were able to identify 46 papers from PubMed and SpringerLink that included the research terms. From these, we included technical details of procedures and gleaned photographs of their works. Additionally, we included photographs from our institution's own plication surgery cases.
CONCLUSIONS
: The field of adult penile reconstruction is performed for a plethora of reasons. From cosmetic to urgent and from routine to complex, it is most certainly a growing subset of Urology that plays a vital role for the men who need it. To our knowledge, this is the most up-to-date review of adult penile reconstruction.
PubMed: 34552786
DOI: 10.1080/2090598X.2021.1957410 -
Translational Andrology and Urology Jun 2016Peyronie's disease (PD), a fibromatous disorder of the tunica albuginea of the penile corpus cavernosum, named after the French physician Francois de la Peyronie, is... (Review)
Review
Peyronie's disease (PD), a fibromatous disorder of the tunica albuginea of the penile corpus cavernosum, named after the French physician Francois de la Peyronie, is characterized by pain, plaque formation, penile curvature, and plaque calcification. The epidemiological data on PD is inconsistent, with recent reports stating a prevalence of up to 9%, and the condition affecting men of all ages, from teenagers to septuagenarians. We are just beginning to elucidate the role of genetics as a causative factor for PD. Chromosomal abnormalities and single-nucleotide polymorphisms have been shown to be associated with fibrotic diatheses. Tunical mechanical stress and microvascular trauma are major contributory factors to the pathophysiology of PD. The diagnosis of PD can be made using a combination of clinical history, physical examination and, sometimes, imaging modalities. A better understanding of the molecular pathophysiology of this condition remains paramount for the development of newer and more effective disease-targeted interventions.
PubMed: 27298774
DOI: 10.21037/tau.2016.04.05 -
Sexual Medicine Dec 2019Surgical intervention in Peyronie's disease (PD) should ideally be delayed until the resolution of acute inflammatory phase. (Review)
Review
INTRODUCTION
Surgical intervention in Peyronie's disease (PD) should ideally be delayed until the resolution of acute inflammatory phase.
AIM
The objective of this review was to highlight the results of penile prosthesis to correct refractory erectile dysfunction (ED) in patients with PD, and the secondary procedures that may be required to correct the penile curvature.
METHODS
A systematic search on PubMed online database using Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations was done using the MeSH terms "Peyronie's disease" and "erectile dysfunction."
MAIN OUTCOME MEASURE
Success and satisfaction rates of various procedures.
RESULTS
The search yielded 324 language-specific (English and Spanish language) articles and 58 articles were retained for final review. The following variables were assessed in different studies: number of patients, types of secondary procedure to correct the curvature, satisfaction rates, and follow-up period.
CONCLUSION
The aim of the surgery in PD should be to achieve a functionally straight penis (<20 degree curvature) with good erection. Patients with refractory ED in PD are candidates for penile prosthesis. Secondary procedures, like manual modeling, plication, plaque incision, or excision grafting, may be required depending on the degree of penile curvature and penile length. In quest for the best graft, TachoSil graft seems to have gained popularity in Europe. Krishnappa P, Fernandez-Pascual E, Carballido J, et al. Surgical Management of Peyronie's Disease With Co-Existent Erectile Dysfunction. Sex Med 2019;7:361-370.
PubMed: 31540882
DOI: 10.1016/j.esxm.2019.08.009