Surgical Treatment of Peyronie’s Disease: A Critical Analysis

Kadıoğlu, Ateş; Akman, Tolga; Şanlı, Öner; Gurkan, Levent; Çakan, Murat; Celtik, Murat

doi:10.1016/j.eururo.2006.04.030

Cited by 123 publications

(87 citation statements)

References 87 publications

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“…In a review of published studies, tunical lengthening and autologous saphenous vein grafting had postoperative erectile dysfunction ranging from 0 to 46%. 20 At presentation, 39% of men in our series were either having difficulty achieving sexual penetration or were unable to perform satisfactory penetrative sexual activity. Our results are similar to a large cross-sectional survey 1 wherein 41% of men with a palpable plaque could not achieve penetrative sexual activity.…”

Section: Discussionmentioning

confidence: 81%

“…2. Patients who have had stable disease for at least 12 months, 6,20 and are unable to achieve penetrative sexual activity with PDE-5 inhibitors, should be assessed with intra-cavernosal prostaglandin injections to determine their erectile potential for the future. 3.…”

Section: Discussionmentioning

confidence: 99%

“…20,22 Patients with more than 601 of angulation, hinge defect, hourglass deformity or other complex deformity should be offered a tunical lengthening procedure or penile prosthesis if they have suboptimal erectile capacity. 20,22 Such patients, however, must be thoroughly counseled regarding the much higher risk of postoperative erectile dysfunction as a consequence of such a procedure. Patients who do not respond to intracavernosal prostaglandin with an erection suitable for penetrative sexual activity should be offered a penile prosthesis.…”

Section: Discussionmentioning

confidence: 99%

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Should assessment of penetrative sexual activity be used as the treatment arbiter in the management of Peyronie's disease?

et al. 2011

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Peyronie's disease is an inflammatory disorder, which causes thickening of the tunica albuginea of the penis. Peyronie's disease has a variable natural history and the assessment and management of the disease has yet to be standardised. The case notes of 97 patients with a diagnosis of Peyronie's disease were retrospectively reviewed at a single tertiary referral centre. Patients who were able to achieve sexual penetrative activity to the satisfaction of both partners were managed conservatively. Patients who were unable to achieve penetrative sexual activity were given intra-cavernosal prostaglandin, with those achieving a satisfactory erection being offered appropriate surgical intervention. The mean age at presentation was 50 years (range 18-82). A total of 59 (61%) men were able to have penetrative sex at the time of presentation. Following initial conservative management, only five (8%) of this group had disease progression, which stopped them from being able to penetrate. In all 38 (39%) men who were not able to penetrate at presentation were offered surgical intervention. In all 24 (63%) of these men chose to have surgical intervention. Tunical plication resulted in the ability to penetrate in 77% of men choosing this option whereas only 46% of men undergoing autologous saphenous vein grafting were able to have penetrative sex. Assessment of penetrative sexual function is an essential component of the management of patients with Peyronie's disease. This enables appropriate counselling with respect to possible conservative management or the most appropriate surgical intervention. The majority of patients with Peyronie's disease can achieve sexual penetrative activity, many without surgical intervention.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Should assessment of penetrative sexual activity be used as the treatment arbiter in the management of Peyronie's disease?

et al. 2011

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“…In general, penile lengthening procedures should be reserved for men with severe penile length loss, curvature greater than 601, or pronounced hourglass deformities. 97 Such procedures involve the incision of the plaque with insertion of graft material to repair the defect. Naturally, this incision and grafting is performed at the site of maximum concavity resulting in lengthening of the penis.…”

Section: Surgical Therapymentioning

confidence: 99%

Peyronie's disease: a critical appraisal of current diagnosis and treatment

2008

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Peyronie's disease is a fibrotic disorder of the tunica albuginea of the penis resulting in varying degrees of penile curvature and sexual dysfunction. Diagnosis of the disorder is made by detailed sexual history and focused physical examination. A wide range of medical treatments has been employed to treat the disorder. Verapamil treatment administered by intraplaque injection is supported by generally consistent randomized controlled trials (RCT). Some RCT evidence exists to support the use of colchicine, potaba, L-carnitine and liposomal superoxide dismutase. Future studies of medical efficacy should focus on improving RCT design, implementation and results reporting to improve the quality of evidence generated by each study. The surgical treatment of Peyronie's disease is a viable and recommended alternative for men with compromised sexual function due to severe curvature or lesions causing penile instability. The choice of corrective procedure should be tailored to each patient after a detailed evaluation of disease severity and sexual function.

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“…Surgery is indicated when disease is stabilized [12,13] and in patients with severe penile curvature and/or erectile dysfunction [14]. Nonsurgical treatments include: potaba, Vitamin E, colchicine, tamoxifen, propolis, verapamil, interferons, collagenase, cortisone, pentoxifylline, iloprost, iontophoresi, Extracorporeal Shock Wave Therapy (ESWT) and Capacitive Resistive Energy Transfer (Tcare or TECAR therapy) [15][16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Pentoxifylline Associated with Other Antioxidants (Multimodal Therapy) on Patients with Peyronie's Disease. Results of a Controlled Study

Paulis¹,

Farina²,

Cavallini³

et al. 2014

Andrology(Los Angel)

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Objective: The study was made mainly to investigate the possible benefits of multimodal treatment using Pentoxifylline (PTX) with other antioxidants, in patients with PD enrolled for a conservative medical management. Methods: We carried out a controlled study on 240 patients diagnosed with Peyronie's Disease (PD). We have divided two treatment groups, which differ from each other only for the association with PTX-penile injection. Two groups (A and B) were totally composed by 160 PD patients (80 patients for each group): Group A=PTX injection (penile and peri-lesional) 100 mg, every two weeks for six months + PTX 400 mg /oral/ twice daily + propolis 600 mg / oral / daily + blueberries 160 mg /oral/ daily + Vitamin E 600 mg / oral / daily + topical Diclofenac sodium 4% gel / twice a day, for a period of 6 months. Group B=the same therapy of group A but without PTX penile injection. Patients who refused treatment, for various reasons, were included in the control group=Group C (80 patients). Results: In groups A and B after 6 months of treatment a reduction of penile plaque volume of 50.3% and 25.9% respectively was observed, while in group C a mean increase in plaque volume of 131% was observed. Furthermore, in groups A and B, the mean curvature decrease was -11.07° and -4.4° respectively, while in group C a mean increase of curvature =+14.09° was observed. Conclusion: Our results showed that multimodal treatment with PTX associated with antioxidants and topical Diclofenac is significantly effective in treating PD. Treatment outcomes obtained in the treatment-group A are statistically more significant than those achieved in group B. Pentoxifylline is more effective when the treatment program includes both routes of administration: oral + perilesional injection.

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Surgical Treatment of Peyronie’s Disease: A Critical Analysis

Cited by 123 publications

References 87 publications

Should assessment of penetrative sexual activity be used as the treatment arbiter in the management of Peyronie's disease?

Should assessment of penetrative sexual activity be used as the treatment arbiter in the management of Peyronie's disease?

Peyronie's disease: a critical appraisal of current diagnosis and treatment

Pentoxifylline Associated with Other Antioxidants (Multimodal Therapy) on Patients with Peyronie's Disease. Results of a Controlled Study

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