Peyronie’s Disease: AUA Guideline

Abstract

Purpose The purpose of this guideline is to provide a clinical framework for the diagnosis and treatment of Peyronie’s disease. Materials and Methods A systematic review of the literature using the PubMed®, EMBASE® and Cochrane databases (search dates 1/1/1965 to 1/26/15) was conducted to identify peer-reviewed publications relevant to the diagnosis and treatment of PD. The review yielded an evidence base of 303 articles after application of inclusion/exclusion criteria. Results The systematic review was used to create guideline statements regarding treatment of PD. When sufficient evidence existed, the body of evidence for a particular treatment was assigned a strength rating of A (high quality evidence; high certainty), B (moderate quality evidence; moderate certainty), or C (low quality evidence; low certainty). Evidence-based statements of Strong, Moderate, or Conditional Recommendation were developed based on benefits and risks/burdens to patients. Additional consensus statements related to the diagnosis of PD are provided as Clinical Principles and Expert Opinions due to insufficient published evidence. Conclusions There is a continually expanding literature on PD; the Panel notes that this document constitutes a clinical strategy and is not intended to be interpreted rigidly. The most effective approach for a particular patient is best determined by the individual clinician and patient in the context of that patient’s history, values, and goals for treatment. As the science relevant to PD evolves and improves, the strategies presented here will be amended to remain consistent with the highest standards of clinical care.

Factors Associated With Erectile Dysfunction and the Peyronie's Disease Questionnaire in Patients With Peyronie Disease

“…Published by Elsevier Inc. P eyronie disease (PD) is a penile condition that is characterized by focal fibrosis of the tunica albuginea that results in the formation of plaque(s), curvature or deformation of the penis, and, in some cases, pain. 1 The prevalence of PD ranges from 3.2% to 11.8% of men, depending on the definition of PD used and the population studied. [2][3][4] The underlying cause of PD is unknown but likely involves abnormal wound healing.…”

“…1 The prevalence of PD ranges from 3.2% to 11.8% of men, depending on the definition of PD used and the population studied. [2][3][4] The underlying cause of PD is unknown but likely involves abnormal wound healing.…”

“…[5][6][7] Most patients with PD present between the ages of 52 and 57 years. 2,8 Although pain typically resolves over time, 1 penile curvature or deformity persists and may impact patients' psychological health, relationships with their sexual partners, and emotional well-being. 9,10 For example, a singlecenter, cross-sectional study demonstrated that more than half of patients with PD experienced relationship problems because of the condition, and 81% reported emotional problems.…”

117 Non-degloving Technique for Peyronie's Disease with Penile Prosthesis Implantation and Double Dorsal-ventral Patch Graft

“…These inelastic plaques alter the anatomic structure of the penis leading to painful erections, erectile dysfunction (ED), and penile deformities. 1,2 Treatment options are based on the severity of the penile deformity and erectile function. While medical therapy and intralesional injections are used to correct mild deformities, persistent PD associated with severe penile deformity or ED indicates the need for surgical management.…”

“…Surgical options include plication, plaque incision and grafting, and penile prosthesis (PP) implantation, with PP implantation as the treatment of choice for medically refractory PD with ED. [1][2][3] In recent years, the "sliding technique" (ST) has been utilized for severe PD with ED as it allows for simultaneous PP implantation and penile length restoration. 4,5 Exposure of the penile shaft for the ST is…”