Advertisement

Current Urology Reports

, 17:60 | Cite as

Peyronie’s Disease: Intralesional Therapy and Surgical Intervention

  • Louis A. Aliperti
  • Akanksha MehtaEmail author
Men’s Health (A Dabaja, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Men’s Health

Abstract

Peyronie’s disease is a collagen wound healing disorder of the penis that negatively affects the quality of life of afflicted men. According to the 2015 AUA Consensus Guidelines on Peyronie’s Disease, minimally invasive intralesional therapies and surgical intervention form the basis of contemporary therapy for this disorder. These therapeutic options, along with selected portions of the guidelines, are explored in this review.

Keywords

Peyronie’s disease Men’s health Minimally invasive surgery Therapy 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no competing interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Sommer F, Schwarzer U, Wassmer G, Bloch W, Braun M, Klotz T, et al. Epidemiology of Peyronie’s disease. Int J Impot Res. 2002;14(5):379–83. doi: 10.1038/sj.ijir.3900863.CrossRefPubMedGoogle Scholar
  2. 2.
    Rhoden EL, Teloken C, Ting HY, Lucas ML, Teodosio da Ros C, Ary Vargas Souto C. Prevalence of Peyronie’s disease in men over 50-y-old from Southern Brazil. Int J Impot Res. 2001;13(5):291–3.CrossRefPubMedGoogle Scholar
  3. 3.
    Schwarzer U, Sommer F, Klotz T, Braun M, Reifenrath B, Engelmann U. The prevalence of Peyronie’s disease: results of a large survey. BJU Int. 2001;88(7):727–30.CrossRefPubMedGoogle Scholar
  4. 4.
    Mulhall JP, Creech SD, Boorjian SA, Ghaly S, Kim ED, Moty A, et al. Subjective and objective analysis of the prevalence of Peyronie’s disease in a population of men presenting for prostate cancer screening. J Urol. 2004;171(6 Pt 1):2350–3.CrossRefPubMedGoogle Scholar
  5. 5.
    El-Sakka AI, Tayeb KA. Peyronie’s disease in diabetic patients being screened for erectile dysfunction. J Urol. 2005;174(3):1026–30. doi: 10.1097/01.ju.0000170231.51306.32.CrossRefPubMedGoogle Scholar
  6. 6.
    Tal R, Heck M, Teloken P, Siegrist T, Nelson CJ, Mulhall JP. Peyronie’s disease following radical prostatectomy: incidence and predictors. J Sex Med. 2010;7(3):1254–61. doi: 10.1111/j.1743-6109.2009.01655.x.CrossRefPubMedGoogle Scholar
  7. 7.
    Nugteren HM, Nijman JM, de Jong IJ, van Driel MF. The association between Peyronie’s and Dupuytren’s disease. Int J Impot Res. 2011;23(4):142–5. doi: 10.1038/ijir.2011.18.CrossRefPubMedGoogle Scholar
  8. 8.
    Devine Jr CJ, Somers KD, Jordan SG, Schlossberg SM. Proposal: trauma as the cause of the Peyronie’s lesion. J Urol. 1997;157(1):285–90.CrossRefPubMedGoogle Scholar
  9. 9.
    Tal R, Mulhall JP. Intracavernosal injections and fibrosis: myth or reality? BJU Int. 2008;102(5):525–6. doi: 10.1111/j.1464-410X.2008.07738.x.CrossRefPubMedGoogle Scholar
  10. 10.
    Mulhall JP, Schiff J, Guhring P. An analysis of the natural history of Peyronie’s disease. J Urol. 2006;175(6):2115–8. doi: 10.1016/S0022-5347(06)00270-9. discussion 8.CrossRefPubMedGoogle Scholar
  11. 11.
    Greenfield JM, Levine LA. Peyronie’s disease: etiology, epidemiology and medical treatment. Urol Clin North Am. 2005;32(4):469–78. doi: 10.1016/j.ucl.2005.08.011. vii.CrossRefPubMedGoogle Scholar
  12. 12.
    El-Sakka AI, Hassoba HM, Pillarisetty RJ, Dahiya R, Lue TF. Peyronie’s disease is associated with an increase in transforming growth factor-beta protein expression. J Urol. 1997;158(4):1391–4.CrossRefPubMedGoogle Scholar
  13. 13.
    Granstein RD, Flotte TJ, Amento EP. Interferons and collagen production. J Invest Dermatol. 1990;95(6 Suppl):75S–80S.CrossRefPubMedGoogle Scholar
  14. 14.
    Duncan MR, Berman B, Nseyo UO. Regulation of the proliferation and biosynthetic activities of cultured human Peyronie’s disease fibroblasts by interferons-alpha, -beta and -gamma. Scand J Urol Nephrol. 1991;25(2):89–94. doi: 10.3109/00365599109024539.CrossRefPubMedGoogle Scholar
  15. 15.
    Ahuja SK, Sikka SC, Hellstrom WJ. Stimulation of collagen production in an in vitro model for Peyronie’s disease. Int J Impot Res. 1999;11(4):207–12.CrossRefPubMedGoogle Scholar
  16. 16.••
    Hellstrom WJ, Kendirci M, Matern R, Cockerham Y, Myers L, Sikka SC, et al. Single-blind, multicenter, placebo controlled, parallel study to assess the safety and efficacy of intralesional interferon alpha-2B for minimally invasive treatment for Peyronie’s disease. J Urol. 2006;176(1):394–8. doi: 10.1016/S0022-5347(06)00517-9. Extremely important reference: This is the only randomized placebo controlled trial testing intralesional interferon administration.CrossRefPubMedGoogle Scholar
  17. 17.
    Lacy 2nd GL, Adams DM, Hellstrom WJ. Intralesional interferon-alpha-2b for the treatment of Peyronie’s disease. Int J Impot Res. 2002;14(5):336–9. doi: 10.1038/sj.ijir.3900867.CrossRefPubMedGoogle Scholar
  18. 18.
    Kelly RB. Pathways of protein secretion in eukaryotes. Science. 1985;230(4721):25–32.CrossRefPubMedGoogle Scholar
  19. 19.
    Askey DB, Herman IM. Computer-assisted analysis of the vascular endothelial cell motile response to injury. Comput Biomed Res. 1988;21(6):551–61.CrossRefPubMedGoogle Scholar
  20. 20.
    Levine LA, Estrada CR. Intralesional verapamil for the treatment of Peyronie’s disease: a review. Int J Impot Res. 2002;14(5):324–8. doi: 10.1038/sj.ijir.3900917.CrossRefPubMedGoogle Scholar
  21. 21.
    Rehman J, Benet A, Melman A. Use of intralesional verapamil to dissolve Peyronie’s disease plaque: a long-term single-blind study. Urology. 1998;51(4):620–6.CrossRefPubMedGoogle Scholar
  22. 22.
    Levine LA, Goldman KE, Greenfield JM. Experience with intraplaque injection of verapamil for Peyronie’s disease. J Urol. 2002;168(2):621–5. discussion 5–6.CrossRefPubMedGoogle Scholar
  23. 23.
    Levine LA, Merrick PF, Lee RC. Intralesional verapamil injection for the treatment of Peyronie’s disease. J Urol. 1994;151(6):1522–4.PubMedGoogle Scholar
  24. 24.
    Shirazi M, Haghpanah AR, Badiee M, Afrasiabi MA, Haghpanah S. Effect of intralesional verapamil for treatment of Peyronie’s disease: a randomized single-blind, placebo-controlled study. Int Urol Nephrol. 2009;41(3):467–71. doi: 10.1007/s11255-009-9522-4.CrossRefPubMedGoogle Scholar
  25. 25.
    Levine LA, Newell M, Taylor FL. Penile traction therapy for treatment of Peyronie’s disease: a single-center pilot study. J Sex Med. 2008;5(6):1468–73. doi: 10.1111/j.1743-6109.2008.00814.x.CrossRefPubMedGoogle Scholar
  26. 26.
    Dhillon S. Collagenase clostridium histolyticum: a review in Peyronie’s disease. Drugs. 2015;75(12):1405–12. doi: 10.1007/s40265-015-0441-7.CrossRefPubMedGoogle Scholar
  27. 27.••
    Gelbard M, Goldstein I, Hellstrom WJ, McMahon CG, Smith T, Tursi J, et al. Clinical efficacy, safety and tolerability of collagenase clostridium histolyticum for the treatment of peyronie disease in 2 large double-blind, randomized, placebo controlled phase 3 studies. J Urol. 2013;190(1):199–207. doi: 10.1016/j.juro.2013.01.087. Extremely important reference: This is the phase 3 trial data for which FDA approval for Xiaflex was granted.CrossRefPubMedGoogle Scholar
  28. 28.
    Inc. AP. US Prescribing Information. Auxilium Pharmaceuticals Inc. 2015. http://www.accessdata.fda.gov/drugsatfda_docs/label/2015/125338s085s087s088lbl.pdf. Accessed 5/21/16 2016.
  29. 29.
    Nehra A, Alterowitz R, Culkin DJ, Faraday MM, Hakim LS, Heidelbaugh JJ, et al. Peyronie’s disease: AUA guideline. J Urol. 2015;194(3):745–53. doi: 10.1016/j.juro.2015.05.098.CrossRefPubMedGoogle Scholar
  30. 30.
    Carson 3rd CC, Sadeghi-Nejad H, Tursi JP, Smith TM, Kaufman GJ, Gilbert K, et al. Analysis of the clinical safety of intralesional injection of collagenase Clostridium histolyticum (CCH) for adults with Peyronie’s disease (PD). BJU Int. 2015;116(5):815–22. doi: 10.1111/bju.13120.CrossRefPubMedGoogle Scholar
  31. 31.
    Mobley EM, Fuchs ME, Myers JB, Brant WO. Update on plication procedures for Peyronie’s disease and other penile deformities. Adv Urol. 2012;4(6):335–46. doi: 10.1177/1756287212448224.CrossRefGoogle Scholar
  32. 32.
    Gholami SS, Lue TF. Correction of penile curvature using the 16-dot plication technique: a review of 132 patients. J Urol. 2002;167(5):2066–9.CrossRefPubMedGoogle Scholar
  33. 33.
    Ralph DJ, Al-kraa M, Pryor JP. The Nesbit operation for Peyronie’s disease: 16-year experience. J Urol. 1995;154(4):1362–3.CrossRefPubMedGoogle Scholar
  34. 34.
    Levine LA, Burnett AL. Standard operating procedures for Peyronie’s disease. J Sex Med. 2013;10(1):230–44. doi: 10.1111/j.1743-6109.2012.03003.x.CrossRefPubMedGoogle Scholar
  35. 35.
    Gelbard MK. Relaxing incisions in the correction of penile deformity due to Peyronie’s disease. J Urol. 1995;154(4):1457–60.CrossRefPubMedGoogle Scholar
  36. 36.
    Kadioglu A, Sanli O, Akman T, Ersay A, Guven S, Mammadov F. Graft materials in Peyronie’s disease surgery: a comprehensive review. J Sex Med. 2007;4(3):581–95. doi: 10.1111/j.1743-6109.2007.00461.x.CrossRefPubMedGoogle Scholar
  37. 37.
    Lentz AC, Carson 3rd CC. Peyronie’s surgery: graft choices and outcomes. Curr Urol Rep. 2009;10(6):460–7.CrossRefPubMedGoogle Scholar
  38. 38.
    Knoll LD, Furlow WL. Corporeal reconstruction and prosthetic implantation for impotence associated with non-dilatable corporeal cavernosal fibrosis. Acta Urol Belg. 1992;60(1):15–25.PubMedGoogle Scholar
  39. 39.
    Hatzichristodoulou G. Partial plaque excision and grafting with collagen fleece in Peyronie disease. J Sex Med. 2016;13(2):277–81. doi: 10.1016/j.jsxm.2015.12.011.CrossRefPubMedGoogle Scholar
  40. 40.
    Hatzichristodoulou G, Gschwend JE, Lahme S. Surgical therapy of Peyronie’s disease by partial plaque excision and grafting with collagen fleece: feasibility study of a new technique. Int J Impot Res. 2013;25(5):183–7. doi: 10.1038/ijir.2013.7.CrossRefPubMedGoogle Scholar
  41. 41.
    Taylor FL, Levine LA. Surgical correction of Peyronie’s disease via tunica albuginea plication or partial plaque excision with pericardial graft: long-term follow up. J Sex Med. 2008;5(9):2221–8. doi: 10.1111/j.1743-6109.2008.00941.x. discussion 9–30.CrossRefPubMedGoogle Scholar
  42. 42.
    Gholami SS, Gonzalez-Cadavid NF, Lin CS, Rajfer J, Lue TF. Peyronie’s disease: a review. J Urol. 2003;169(4):1234–41. doi: 10.1097/01.ju.0000053800.62741.fe.CrossRefPubMedGoogle Scholar
  43. 43.
    Trost L, Wanzek P, Bailey G. A practical overview of considerations for penile prosthesis placement. Nat Rev Urol. 2016;13(1):33–46. doi: 10.1038/nrurol.2015.270.CrossRefPubMedGoogle Scholar
  44. 44.
    Garaffa G, Minervini A, Christopher NA, Minhas S, Ralph DJ. The management of residual curvature after penile prosthesis implantation in men with Peyronie’s disease. BJU Int. 2011;108(7):1152–6. doi: 10.1111/j.1464-410X.2010.10023.x.CrossRefPubMedGoogle Scholar
  45. 45.
    Levine LA, Benson J, Hoover C. Inflatable penile prosthesis placement in men with Peyronie’s disease and drug-resistant erectile dysfunction: a single-center study. J Sex Med. 2010;7(11):3775–83. doi: 10.1111/j.1743-6109.2010.01971.x.CrossRefPubMedGoogle Scholar
  46. 46.•
    Chung PH, Scott JF, Morey AF. High patient satisfaction of inflatable penile prosthesis insertion with synchronous penile plication for erectile dysfunction and Peyronie’s disease. J Sex Med. 2014;11(6):1593–8. 10.1111/jsm.12530. Important reference: This paper explores combinging plication and IPP placement.CrossRefPubMedGoogle Scholar
  47. 47.•
    Levine LA, Larsen SM. Surgical correction of persistent Peyronie’s disease following collagenase clostridium histolyticum treatment. J Sex Med. 2015;12(1):259–64. doi: 10.1111/jsm.12721. Important reference: This paper suggests collagenase administration is not a contraindication to surgical intervention.CrossRefPubMedGoogle Scholar
  48. 48.
    LaRochelle JC, Levine LA. A Survey of primary-care physicians and urologists regarding Peyronie’s disease. J Sex Med. 2007;4(4 Pt 2):1167–73. doi: 10.1111/j.1743-6109.2007.00537.x.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of UrologyEmory University School of MedicineAtlantaUSA

Personalised recommendations