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Peyronie’s Disease: Intralesional Therapy and Surgical Intervention

  • Men’s Health (A Dabaja, Section Editor)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

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.

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References

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

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  13. Granstein RD, Flotte TJ, Amento EP. Interferons and collagen production. J Invest Dermatol. 1990;95(6 Suppl):75S–80S.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  18. Kelly RB. Pathways of protein secretion in eukaryotes. Science. 1985;230(4721):25–32.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  23. Levine LA, Merrick PF, Lee RC. Intralesional verapamil injection for the treatment of Peyronie’s disease. J Urol. 1994;151(6):1522–4.

    CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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. 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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  35. Gelbard MK. Relaxing incisions in the correction of penile deformity due to Peyronie’s disease. J Urol. 1995;154(4):1457–60.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  37. Lentz AC, Carson 3rd CC. Peyronie’s surgery: graft choices and outcomes. Curr Urol Rep. 2009;10(6):460–7.

    Article  PubMed  Google Scholar 

  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.

    CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Emory University School of Medicine, 1365 Clifton Road, NE, Building B, Suite 1400, Atlanta, GA, 30322, USA

    Louis A. Aliperti & Akanksha Mehta

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  1. Louis A. Aliperti
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  2. Akanksha Mehta
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Correspondence to Akanksha Mehta.

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

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Aliperti, L.A., Mehta, A. Peyronie’s Disease: Intralesional Therapy and Surgical Intervention. Curr Urol Rep 17, 60 (2016). https://doi.org/10.1007/s11934-016-0622-2

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