Role of Oxidative Stress in Peyronie’s Disease: Biochemical Evidence and Experiences of Treatment with Antioxidants

Abstract

Background: Peyronie’s disease (PD) is a chronic inflammatory condition affecting adult males, involving the tunica albuginea of the corpora cavernosa of the penis. PD is frequently associated with penile pain, erectile dysfunction, and a secondary anxious–depressive state. The etiology of PD has not yet been completely elucidated, but local injury is generally recognized to be a triggering factor. It has also been widely proven that oxidative stress is an essential, decisive component in all inflammatory processes, whether acute or chronic. Current conservative medical treatment comprises oral substances, penile injections, and physical therapy. Aim: This article intends to show how antioxidant therapy is able to interfere with the pathogenetic mechanisms of the disease. Method: This article consists of a synthetic narrative review of the current scientific literature on antioxidant therapy for this disease. Results: The good results of the antioxidant treatment described above also prove that the doses used were adequate and the concentrations of the substances employed did not exceed the threshold at which they might have interacted negatively with the mechanisms of the redox regulation of tissue. Conclusions: We believe new, randomized, controlled studies are needed to confirm the efficacy of treatment with antioxidants. However, we consider the experiences of antioxidant treatment which can already be found in the literature useful for the clinical practice of urologists in the treatment of this chronic inflammatory disease.

Congenital penile curvature as a possible risk factor for the onset of Peyronie's disease, and psychological consequences of penile curvature

“…According to this hypothesis, CPC would favor traumatic events of different degrees of severity during coitus (36)(37)(38). In fact, repeated intercoital thrusts can cause microtraumas in the context of the tunica albuginea of the corpora cavernosa, thus giving rise to the events underlying the formation of the plaque: delamination of the tunica albuginea, micro-hematoma, accumulation of fibrin, recruitment of macrophages, lymphocytes, platelets and fibroblasts, production of pro-inflammatory cytokines, and production and accumulation of collagen (26,39). The present study was aimed at studying the relationship between a history of congenital penile curvature and Peyronie's disease.…”

Ultrasound Elastography as a Diagnostic Tool for Peyronie’s Disease: A State-of-the-Art Review

“…In individuals not genetically susceptible to the disease, the hematoma is typically reabsorbed. However, in individuals with a genetic predisposition, the hematoma causes local recruitment of inflammatory cells and pro-inflammatory cytokines, resulting in the formation of chronic inflammatory tissue that subsequently progresses to fibrosis [ 27 , 28 , 29 ]. Over the past 20 years, research has shown that oxidative stress (OS) plays a critical role in plaque formation and in the progression of PD [ 28 , 29 , 30 , 31 , 32 , 33 , 34 ].…”

Measurement of Oxidative Stress Index (OSI) in Penile Corpora Cavernosa and Peripheral Blood of Peyronie’s Disease Patients: A Report of 49 Cases

“…PD presents in a unifocal manner (single plaque) in the majority of cases (78–84%) but can also occur in multiple areas of the penile corpora cavernosa [ 9 ]. Over the last two decades, oxidative stress (OS) has proven to be very important and crucial for plaque formation and the evolution of the disease itself [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. The disease presents and evolves in two phases.…”

“…The second phase of PD consists of the stabilization of PD with the consequent stabilization of the deformation and the disappearance of pain. This is the phase of the disease where surgical intervention is indicated (corporoplasty, plaque incision, and/or implantation of penile prosthesis) [ 7 , 19 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ]. Peyronie’s fibrous plaque can calcify in approximately 20–36% of cases [ 47 , 48 ].…”