section name header
Information
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Editors
Mika
Raitanen
Peyronie's Disease (Induratio Penis Plastica)
Definition and aetiology
A fibrotic induration of corpus cavernosum
The aetiology is unknown; however, some patients (9-39%) have Dupuytren contracture of the palms.
Symptoms and signs
The skin is normal and freely mobile at the site of induration.
The penis is curved in the direction of the induration during erection. In one third of the patients, the symptoms include erectile pain.
In differential diagnosis consider the spread of prostatic carcinoma into the penis (palpate the prostate).
Pictures taken by the patient showing the curvature of the penis during erection are very useful when evaluating the symptom.
Ultrasound imaging is usually not beneficial.
Treatment
In a large share of patients, the condition remains the same or even improves over time.
The painful phase may last several months.
Most patients are capable of sexual intercourse and no therapy is then indicated.
Refer to a urologist if the penis is markedly curved.
There is no pharmacotherapy available in Europe, and in some other countries, after an injectable proteinase (collagenase clostridium histolyticum, injected into the induration)
http://www.dynamed.com/condition/peyronie-disease-17#INTRALESIONAL_THERAPIES
has left the market (see e.g.
http://www.ema.europa.eu/en/medicines/human/EPAR/xiapex
and
http://health-products.canada.ca/dpd-bdpp/info.do?lang=en&code=87384
). The drug is still available in the US, with warnings of potential serious adverse effects.
Possible corrective surgery is not performed until the painful phase is over and the condition has remained stable for at least 3 months
http://www.dynamed.com/condition/peyronie-disease-17#SURGERY_AND_PROCEDURES
.
References
Russo GI, Milenkovic U, Hellstrom W et al. Clinical Efficacy of Injection and Mechanical Therapy for Peyronie's Disease: A Systematic Review of the Literature. Eur Urol 2018;74(6):767-781.
[PubMed]
Related Keywords
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ATC Code:
M09AB02
Primary/Secondary Keywords
Penile Induration
Penis
Peyronie's disease
Peyronie disease
Induratio penis plastica
plastic induration of the penis
penile fibromatosis
curved penis
Penile Erection
Contracture
cavernous body of the penis
Surgery
Urology
Y99
N48.6