Peyronie’s disease(PD)presents a multifaceted challenge in contemporary urological practice,marked by penile deformity,pain,and the potential for erectile dysfunction.We meticulously explored the existing literature ...Peyronie’s disease(PD)presents a multifaceted challenge in contemporary urological practice,marked by penile deformity,pain,and the potential for erectile dysfunction.We meticulously explored the existing literature of intralesional/topical interventions,aiming to provide clinicians with a nuanced understanding of available options for comprehensive PD management.To conduct this review,we performed a systematic search using the PubMed,Scopus,and ScienceDirect databases,including the keywords of combination of the“Peyronie’s disease/plastic induration of the penis(PIP)and intralesional/topical treatments”.The study selection was based on adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines,resulting in the inclusion of 16 articles.We delve into the effectiveness and safety profiles of collagenase Clostridium histolyticum(CCH),interferon,platelet-rich plasma(PRP),hyaluronic acid,botulinum toxin,stem cell,extracorporeal shock wave therapy(ESWT),and traction therapy,assessing their impact on penile curvature,length improvement,and patient-reported symptoms and outcomes.The best options evaluated are intralesional injections of CCH and penile traction devices,alone or in combination.Despite PD remains a challenge for urologists,the objective of this review is to contribute to the evolving landscape of PD management,fostering informed decision-making,and personalized care for individuals grappling with this challenging condition.展开更多
Aim： To discuss important points on medical history, preoperative evaluation, real expectations, and selection of the appropriate surgical procedure to improve patient satisfaction after surgical procedures for Peyro...Aim： To discuss important points on medical history, preoperative evaluation, real expectations, and selection of the appropriate surgical procedure to improve patient satisfaction after surgical procedures for Peyronie＇s disease. Methods： Recent advances in approaches to Peyronie＇s disease are discussed based on the literature and personal experiences. Issues concerning surgical indication, patient selection, surgical techniques, and grafting are discussed. Lengthening procedures on the convex side of the penile curvature by means of grafting offer the best possible gain from a reconstruction standpoint. Penile rectification and rigidity are required to achieve a completely functional penis. Most patients experience associated erectile dysfunction （ED）, and penile straightening alone may not be enough to restore complete function. Twenty-five patients were submitted to total penile reconstruction on length and girth with concomitant penile prosthesis implant. The maximum length restoration was possible and limited by the length of the dissected neurovascular bundle. The mean age was 55.4 years （32-69 years） and the mean angle of curvature 74.2± 22.4° （0-100°）. Pericardial grafting was used to cover the defect. The mean follow-up time was 11.2 ± 5.9 months （3-22 months）. Results： Mean functional penile length gain was 3.40 ＋ 0.73 cm （2-5 cm）. Penile prosthesis maintained the penis straight. No infections occurred. Sexual intercourse was restored in all patients and all reported recovered self-esteem. Conclusion： Improving patient satisfaction with the surgical treatment includes proper preoperative evaluation on stable disease, penile shortening, vascular and erectile status, patient decision and selection as well as extensive discussion on surgical technique for restoring functional penis （length and rigidity）. Length and girth restoration is very important for self-esteem and patient satisfaction.展开更多
文摘Peyronie’s disease(PD)presents a multifaceted challenge in contemporary urological practice,marked by penile deformity,pain,and the potential for erectile dysfunction.We meticulously explored the existing literature of intralesional/topical interventions,aiming to provide clinicians with a nuanced understanding of available options for comprehensive PD management.To conduct this review,we performed a systematic search using the PubMed,Scopus,and ScienceDirect databases,including the keywords of combination of the“Peyronie’s disease/plastic induration of the penis(PIP)and intralesional/topical treatments”.The study selection was based on adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines,resulting in the inclusion of 16 articles.We delve into the effectiveness and safety profiles of collagenase Clostridium histolyticum(CCH),interferon,platelet-rich plasma(PRP),hyaluronic acid,botulinum toxin,stem cell,extracorporeal shock wave therapy(ESWT),and traction therapy,assessing their impact on penile curvature,length improvement,and patient-reported symptoms and outcomes.The best options evaluated are intralesional injections of CCH and penile traction devices,alone or in combination.Despite PD remains a challenge for urologists,the objective of this review is to contribute to the evolving landscape of PD management,fostering informed decision-making,and personalized care for individuals grappling with this challenging condition.
文摘Aim： To discuss important points on medical history, preoperative evaluation, real expectations, and selection of the appropriate surgical procedure to improve patient satisfaction after surgical procedures for Peyronie＇s disease. Methods： Recent advances in approaches to Peyronie＇s disease are discussed based on the literature and personal experiences. Issues concerning surgical indication, patient selection, surgical techniques, and grafting are discussed. Lengthening procedures on the convex side of the penile curvature by means of grafting offer the best possible gain from a reconstruction standpoint. Penile rectification and rigidity are required to achieve a completely functional penis. Most patients experience associated erectile dysfunction （ED）, and penile straightening alone may not be enough to restore complete function. Twenty-five patients were submitted to total penile reconstruction on length and girth with concomitant penile prosthesis implant. The maximum length restoration was possible and limited by the length of the dissected neurovascular bundle. The mean age was 55.4 years （32-69 years） and the mean angle of curvature 74.2± 22.4° （0-100°）. Pericardial grafting was used to cover the defect. The mean follow-up time was 11.2 ± 5.9 months （3-22 months）. Results： Mean functional penile length gain was 3.40 ＋ 0.73 cm （2-5 cm）. Penile prosthesis maintained the penis straight. No infections occurred. Sexual intercourse was restored in all patients and all reported recovered self-esteem. Conclusion： Improving patient satisfaction with the surgical treatment includes proper preoperative evaluation on stable disease, penile shortening, vascular and erectile status, patient decision and selection as well as extensive discussion on surgical technique for restoring functional penis （length and rigidity）. Length and girth restoration is very important for self-esteem and patient satisfaction.
