Peyronie's disease
Peyronie's disease | |
---|---|
Other names | Peyronie disease, induratio penis plastica (IPP),[1] chronic inflammation of the tunica albuginea (CITA) |
Man showing abnormal curvature of the penis associated with Peyronie's disease | |
Pronunciation | |
Specialty | Urology |
Causes | Unknown[2] |
Frequency | ~10% of men[2] |
Named after | François Gigot de la Peyronie |
Peyronie's disease is a
It is estimated to affect 1–20% of men.[2] The condition becomes more common with age.[2]
Signs and symptoms
A certain degree of curvature of the penis is considered normal, as many people are born with this benign condition, commonly referred to as congenital curvature.[4] The disease may cause pain; hardened, big, cord-like lesions (scar tissue known as "plaques"); or abnormal curvature of the penis when erect due to chronic inflammation of the tunica albuginea (CITA).[5]
Although the popular conception of Peyronie's disease is that it always involves curvature of the penis, the scar tissue sometimes causes divots or indentations rather than curvature. The condition may also make
Psychosocial
Peyronie's disease can also have psychological effects. While most men will continue to be able to have sexual relations, they are likely to experience some degree of erectile dysfunction. It is not uncommon to exhibit depression or withdrawal from their sexual partners.[7]
Causes
The underlying cause of Peyronie's disease is unknown. Although, it is likely due to a buildup of plaque inside the penis due to repeated mild sexual trauma or injury during sexual intercourse or physical activity.[8]
Risk factors include
Diagnosis
A urologist may be able to diagnose the disease and suggest treatment. An ultrasound can provide conclusive evidence of Peyronie's disease, ruling out congenital curvature or other disorders.[12]
Ultrasonography
On
In the Doppler study, increased flow around the plaques can suggest inflammatory activity and the absence of flow can suggest disease stability. Ultrasound is useful for the identification of lesions and to determine their relationship with the neurovascular bundle. Individuals with Peyronie's disease can present with erectile dysfunction, often related to venous leakage, due to insufficient drainage at the site of the plaque. Although plaques are more common on the dorsum of the penis, they can also be seen on the ventral face, lateral face, or septum.[13]
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Transverse ultrasound of the penis, in a ventral view, in the middle portion of the penis. Note the echoic image with posterior acoustic shadowing, corresponding to calcification (arrow), in the left corpus cavernosum.[13]
Treatment
Medication and supplements
Many oral treatments have been studied but results so far have been mixed.[14] Some consider the use of nonsurgical approaches to be controversial.[15]
Collagenase clostridium histolyticum is reported to help by breaking down the excess collagen in the penis.[18][19] It was approved for treatment of Peyronie's disease by the FDA in 2013.[20]
The effects of tadalafil in treating the disease have also been studied.[21][22]
Physical therapy and devices
There is moderate evidence that penile traction therapy is a well-tolerated, minimally invasive treatment; there is uncertainty about the optimal duration of stretching per day and per course of treatment, and the treatment course is difficult.[23]
Surgery
Surgery such as the "Nesbit operation", which is named after
Epidemiology
It is estimated to affect 1–20% of men.[2] The condition becomes more common with age.[2] The mean age at onset of disease is 55–60 years although many cases have been recorded in adolescence and early 20's.[8][25]
The overall prevalence of PD is about 1–20% in men. Rates range from 3.2 percent in a community-based survey of 4432 men (mean age of sample 57.4) to 16 percent among 488 men undergoing evaluation for erectile dysfunction (mean age 52.8).[26][27] The prevalence of PD among the 4432 men in the community based study who responded by self report positively for palpable plaque, newly occurring angulation or curvature and painful erection was 1.5 percent between the ages of 30 and 39, 3 percent between 40 and 49, 3 percent between 50 and 59, 4 percent between 60 and 69, and 6.5 percent over 70.
In 534 men undergoing routine prostate screening for cancer detection (without a specific urologic complaint), the prevalence of PD was 8.9 percent.[26] In this study, the mean age of those with PD was 68.2 years compared with 61.8 years of those without PD.
History
The condition was first described in 1561 in correspondence between Andreas Vesalius and Gabriele Falloppio and separately by Gabriele Falloppio.[28][29] The condition is named for François Gigot de la Peyronie, who described it in 1743.[30]
References
- ISBN 978-0-07-138076-8.
- ^ a b c d e f g "Penile Curvature (Peyronie's Disease)". National Institute of Diabetes and Digestive and Kidney Diseases. July 2014. Retrieved 25 October 2017.
- .
- ISBN 9780781791410.
- ISBN 978-981-10-3694-1.
- PMID 9636000.
- PMID 23153101.
- ^ S2CID 38211880.
- ISBN 9783319315874. Retrieved 2020-01-17.
- PMID 22658761. Retrieved 21 January 2020.
- PMID 19649505.
- PMID 8319059.
- ^ license
- PMID 14551587.
- PMID 16698449.
- PMID 12454684.
- S2CID 10578409.
- ^ "FDA approves first drug treatment for Peyronie's disease". FDA NEWS RELEASE. U.S. Food and Drug Administration. 6 December 2013. Retrieved 6 December 2013.
- ^ Pollack, Andrew (December 6, 2013). "Injections to Treat an Embarrassing Ailment Win U.S. Approval". New York Times. Retrieved December 7, 2013.
- ISBN 9783319658223. Retrieved 2020-01-17.)
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: CS1 maint: multiple names: authors list (link - S2CID 254674530.
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- PMID 14551588.
- PMID 21981606.
- ^ a b Mulhall JP, Creech SD, Boorjian SA, Ghaly S, Kim ED, Moty A, Davis R, Hellstrom W. Subjective and objective analysis of the prevalence of Peyronie's disease in a population of men presenting for prostate cancer screening. J Urol. 2004 Jun;171(6 Pt 1):2350-3. doi: 10.1097/01.ju.0000127744.18878.f1. PMID 15126819.
- ^ Kadioglu A, Oktar T, Kandirali E, Kendirci M, Sanli O, Ozsoy C. Incidentally diagnosed Peyronie's disease in men presenting with erectile dysfunction. Int J Impot Res. 2004 Dec;16(6):540-3. doi: 10.1038/sj.ijir.3901247. PMID 15116064.
- PMID 8944520.
- ^ Falloppio, Gabriele (1561). Gabrielis Falloppii medici Mutinensis Observationes anatomicae ad Petrum Mannam medicum Cremonensem . U.S. National Library of Medicine. Venetiis : Apud Marcum Antonium Vlmum.
- Who Named It?