Peyronie's disease: evidence-based knowledge and hypotheses in its pathophysiology, epidemiology, diagnosis and treatment

作者：Journel N Morel^*; Ruffion A; Campos Fernandes J L; Grima F; Leriche A

来源：Pelvi-Perineologie, 2007, 2(2): 135-143.

DOI：10.1007/s11608-007-0124-2

• La Peyronie's disease
• surgery
• curvature
• penis
• pain

Subject: Although still poorly understood, La Peyronie's disease has been described for two hundred years. This lack of solid knowledge explains the existence of so many etiopathogenic hypotheses, despite the current emerging consensus.
Method: We performed an exhaustive review of the major studies and conference reports on La Peyronie's disease since 2004 to determine present thinking on this condition.
Results: The microtrauma hypothesis remains valid today but is not comprehensive enough to fully explain aetiology; explanations touching on autoimmunity, genetics and the vascular system are necessary to better understand the disease. Clinical examination suffices for establishing diagnosis. Medical treatment has mostly succeeded in managing pain. Vitamin E, colchicine, steroid and intraplaque verapamil injections are now accepted treatments. Further studies are needed to determine the efficacy of treatment with phosphodiesterase type 5 or beta interferon intraplaque injection. Surgical treatments are appropriate only if the disease has stabilized after six months. Erection quality, penis size, degree of curvature and the patient's wishes are the main factors to consider before choosing a surgical treatment. The reference for curvature correction is the Nesbit procedure. If the plaque is large and accompanied by impotence, plaque incision with vein graft and the insertion of an inflatable prosthesis is the usual treatment course. Leriche's technique, soft prostheses, and extracorporeal shockwaves offer promising alternatives but require further investigations to prove their effectiveness.

• 出版日期2007-6