Review of Management Options for Patients With Atypical Peyronie's Disease

Published on Apr 1, 2017in Sexual medicine reviews
· DOI :10.1016/j.sxmr.2016.07.004
Faysal A. Yafi19
Estimated H-index: 19
(Tulane University),
Georgios Hatzichristodoulou14
Estimated H-index: 14
(TUM: Technische Universität München)
+ 1 AuthorsWayne J.G. Hellstrom63
Estimated H-index: 63
(Tulane University)
Abstract Introduction Peyronie's disease (PD) is a wound-healing disorder of the tunica albuginea often associated with penile deformity. Less commonly, patients with PD might display atypical presentations such as ventral curvature, hourglass deformity, significantly shortened penis, and/or multiplanar curvature. Aim To review the available literature on the prevalence of and management options for atypical PD. Methods A literature review was performed through PubMed from 1982 through 2016 regarding atypical PD. Keywords used for the search were Peyronie's disease, atypical Peyronie's disease, ventral Peyronie's disease, ventral plaque, hourglass deformity, penile indentation, penile notching, short penis, shortened penis, shrunken penis, biplanar curvature, and multiplanar curvature. Main Outcome Measures To assess the various surgical and non-surgical techniques used for the management of atypical PD. Results Collagenase Clostridium histolyticum is contraindicated for patients with ventral plaques and/or hourglass deformities. Patients with maintained erectile function and ventral PD plaques are best treated with intralesional injections of interferon alpha-2b or tunica plication. Patients with maintained erectile function with PD associated with hourglass deformity and/or multiplanar curvature are best treated with plaque incision or partial excision and grafting. Patients with a shortened penis could attempt conservative measures such as penile traction therapy and medical management. When erectile function is compromised, insertion of an inflatable penile prosthesis with or without ancillary straightening procedures should be recommended. Lengthening procedures can be attempted in very special circumstances by expert surgeons. Conclusion There is a paucity of data regarding atypical PD. Ventral plaques can be treated with intralesional injections or surgery, hourglass deformity and multiplanar curvatures are best managed surgically, and a shortened penis should be treated with non-invasive approaches. When concomitant erectile dysfunction is present, insertion of an inflatable penile prosthesis is recommended. Caution should be advised before undergoing ancillary penile lengthening maneuvers owing to the potential for serious complications. Yafi FA, Hatzichristodoulou G, DeLay KJ, Hellstrom WJG. Review of Management Options for Patients With Atypical Peyronie's Disease. Sex Med Rev 2017;5:211–221.
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#1Faysal A. Yafi (Tulane University)H-Index: 19
#2Georgios Hatzichristodoulou (TUM: Technische Universität München)H-Index: 14
Last. Wayne J.G. Hellstrom (Tulane University)H-Index: 63
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Abstract Introduction Approximately 10% of Peyronie's disease (PD) patients present with ventral curvatures and, as such, there is a paucity of data describing the optimal approach for treatment. Aim This study aims to compare the outcomes of surgery (tunical plication [TP]) and intralesional injection (ILI) therapy (interferon‐α2b) in men with ventral PD. Materials and Methods Retrospective data were collected from two centers: Tulane University (ILI) and Technical University of Munich (TP). Co...
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Abstract Introduction Despite recent advances in our knowledge and treatment strategies in Peyronie's Disease (PD), much remained unknown about this disease. Aim To provide a clinical framework and key guideline statements to assist clinicians in an evidence-based management of PD. Methods A systematic literature search was conducted to identify published literature relevant to PD. The search included all relevant articles published up to June 2015, including preclinical studies and published gu...
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Objectives To report the results from a prospective multicentric study of patients with Peyronie's disease (PD) treated with the ‘sliding’ technique (ST). Patients and Methods From June 2010 to January 2014, 28 consecutive patients affected by stable PD with severe penile shortening and end-stage erectile dysfunction (ED) were enrolled in three European PD tertiary referral centres. The validated International Index of Erectile Function (IIEF) questionnaire, the Sexual Encounter Profile (SEP) Qu...
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#1Faysal A. Yafi (Tulane University)H-Index: 19
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Objective To investigate the outcomes of two surgical interventions for Peyronie's disease (PD) with hourglass deformity: partial excision and grafting (PEG) or inflatable penile prosthesis (IPP) implantation. Materials and Methods Retrospective data were collected from two centers: Technical University of Munich (PEG) and Tulane University Medical Center (IPP). Collected variables included patient demographics, sexual function, penile vascular measurements, and treatment outcomes. Results A tot...
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