Standard Operating Procedures for Peyronie's Disease

Abstract

Introduction Peyronie's disease (PD) refers to a penile deformity that is associated with sexual dysfunction. Aim To provide recommendations and Standard Operating Procedures (SOPs) based on best evidence for diagnosis and treatment of PD. Methods Medical literature was reviewed and combined with expert opinion of the authors. Main Outcome Measures Recommendations and SOPs based on grading of evidence–based medical literature. Results PD is a fibrotic wound-healing disorder involving the tunica albuginea of the corpora cavernosa. The resulting scar is responsible for a variety of deformities, including curvature, shortening, narrowing with hinge effect, and is frequently associated in the early phase with pain. Patients frequently experience diminished quality erections. All of these conditions can compromise sexual function for the affected male. The etiopathophysiology of PD has yet to be clarified and as a result, effective, reliable, mechanistic directed non-surgical therapy is lacking. Conclusions The management of PD consists of proper diagnosis and treatment, ranging from non-surgical to surgical interventions. The main state of treatment for PD rests at this time on surgical correction that should be based on clear indications, involve surgical consent, and follow a surgical algorithm that includes tunica plication, plaque incision/partial excision and grafting, and penile prosthesis implantation.

An overview on therapeutic potential and various applications of microbial collagenases

“…Intralesional collagenase is the first U.S. FDA approved drug for the treatment of Peyronie's disease. It works by breaking down the extra collagen in the penis that causes this disease [115]. A multicenter, double-blind, phase 3 randomized and placebo-controlled trial supports the efficacy and safety of intralesional CCH in the treatment of the subjective and objective aspects of significant Peyronie's disease in patients with curvature between 30° and 90° [116,117].…”

1124 The Egydio geometrical procedure for managing penile curvature using a single relaxing incision: A single-centre experience with 330 patients

“…There is no easy answer to the difficult question of the ideal operation for the treatment of Peyronie's disease [5]. The Egydio technique, using a single relaxing incision forked at both ends (i.e.…”

Recent surgical advances in Peyronie’s Disease

“…An history of penile trauma must be sought (reported in 5% -13% of cases) 5 as well as Dupuytren's contracture (associated risk of 3% -22 % of PD), Ledderhose disease and tympanosclerosis. 5,11,12 Important determinations during consultation are regular measures of stretched penile length, girth measurement, penile sensation to touch and degree of penile curvature. 13 Patient self-reporting of penile curvature is unreliable and should not be used as a clinical objective marker and an objective evaluation through a proper clinical examination of the erect penis (induced pharmacologically) is needed.…”