II. Epidemiology
- Males aged 45 to 65 years old
III. History
- Named for Italian physician to King Louis XIV of France
IV. Pathophysiology
V. Associated Conditions: Dupuytren's Contracture (47%)
- Palmar Fibrosis
- Plantar Fibrosis
VI. Differential Diagnosis
VII. Symptoms
VIII. Signs
- Firm, nontender Plaques
- Location
- Lateral corpora cavernosa
- Dorsal over intercorporeal septum
IX. Course
- Penile Plaque forms, scars and remodels over first year
- Spontaneous resolution in 20 to 50% of younger men
- Scarring progresses to calcification in 25% of men
- Calcification progresses to bone in 25% of men
X. Management: Non-surgical
-
Vitamin E 100 mg PO tid for over 4 months
- Evidence suggests no better than Placebo
- Verapamil intralesional injection
- Potassium Aminobenzoate 2 g PO 6x/day for 6-12 months
-
Corticosteroid intralesional injection
- Use small gauge needle with no Anesthetic
- Most effective if used early in Peyronie's Disease
- Decadron 0.2-0.4 mg per Plaque weekly for 10 weeks
- Aristospan 2 mg per Plaque every 6 weeks for 36 weeks
- Avoid intercourse during treatment to avoid Trauma
XI. Management: Surgical
- Nesbit Procedure
- Plaque excision with patch grafting of defect
XII. References
- Degowin (1987) Diagnostic Exam, Macmillan, p. 606-7
- Fitkin (1999) Am Fam Physician 60(2): 549-52 [PubMed]