Peyronie's Disease

Aka: Peyronie's Disease, Peyronie's Syndrome, Plastic Induration of the penis, Induratio Penis Plastica, Strabismus Penis

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II. Epidemiology

  1. Males aged 45 to 65 years old

III. History

  1. Named for Italian physician to King Louis XIV of France

IV. Pathophysiology

  1. Diminished elasticity of Collagen of penis
  2. Irregular fibrosis of the corpora cavernosa of penis
    1. Fibrosis of septum or sheath
    2. Extends into tunica albuginea
  3. Spares corpus cavernosum Urethra

V. Associated Conditions: Dupuytren's Contracture (47%)

  1. Palmar Fibrosis
  2. Plantar Fibrosis

VI. Differential Diagnosis

  1. Tertiary Syphilis Gumma
  2. Scleroderma
  3. Alcohol Abuse
  4. Diabetes Mellitus
  5. Local Trauma
  6. Gouty Tophi

VII. Symptoms

  1. Focal pain with Erection (50 to 66%)
    1. Pain resolves as inflammation subsides
  2. Lateral curvature of the penis during Erection
  3. Penis flail distal to lesion

VIII. Signs

  1. Firm, nontender Plaques
  2. Location
    1. Lateral corpora cavernosa
    2. Dorsal over intercorporeal septum

IX. Course

  1. Penile Plaque forms, scars and remodels over first year
  2. Spontaneous resolution in 20 to 50% of younger men
  3. Scarring progresses to calcification in 25% of men
  4. Calcification progresses to bone in 25% of men

X. Management: Non-surgical

  1. Vitamin E 100 mg PO tid for over 4 months
    1. Evidence suggests no better than Placebo
  2. Verapamil intralesional injection
  3. Potassium Aminobenzoate 2 g PO 6x/day for 6-12 months
  4. Corticosteroid intralesional injection
    1. Use small gauge needle with no Anesthetic
    2. Most effective if used early in Peyronie's Disease
    3. Decadron 0.2-0.4 mg per Plaque weekly for 10 weeks
    4. Aristospan 2 mg per Plaque every 6 weeks for 36 weeks
  5. Avoid intercourse during treatment to avoid Trauma

XI. Management: Surgical

  1. Nesbit Procedure
    1. Plaque excision with patch grafting of defect

XII. References

  1. Degowin (1987) Diagnostic Exam, Macmillan, p. 606-7
  2. Fitkin (1999) Am Fam Physician 60(2): 549-52 [PubMed]

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Related Studies

Ontology: Peyronie Disease (C0030848)

Definition (NCI) Fibromatosis arising from the soft tissues of the penis. It is characterized by the presence of spindle-shaped fibroblasts, and an infiltrative growth pattern. It causes the penis to bend when it becomes erect.
Definition (MSH) A condition characterized by hardening of the PENIS due to the formation of fibrous plaques on the dorsolateral aspect of the PENIS, usually involving the membrane (tunica albuginea) surrounding the erectile tissue (corpus cavernosum penis). This may eventually cause a painful deformity of the shaft or constriction of the urethra, or both.
Concepts Disease or Syndrome (T047)
MSH D010411
ICD9 607.85
ICD10 N48.6
SnomedCT 1335005, 155931002, 198028006
English Cavernitides, Fibrous, Cavernitis, Fibrous, Fibrous Cavernitides, Fibrous Cavernitis, Penile Induration, Peyronie Disease, Peyronie's Disease, Peyronies Disease, PEYRONIE'S DISEASE, Penile induration, Penile Fibromatosis, Fibromatosis, Penile, Plastic Induration of the Penis, PEYRONIE DISEASE, PEYRONIES DIS, PEYRONIE DIS, Peyronie's disease (diagnosis), Penile Induration [Disease/Finding], disease peyronie, peyronies disease, diseases peyronie, diseases peyronies, Disease;Peyronies, disease peyronie's, penile induration, peyronie's disease, penile fibrosis, peyronie disease, induratio penis plastica, Peyronies disease, Peyronie's disease (disorder), Fibrous cavernitis, Indurated penis plastica, Penile fibromatosis, Fibrous cavernositis, Plastic induration of penis, Peyronie's disease, Induratio penis plastica, Induratio penis plastica (disorder), Peyronie, induration; penile, penile; induration, Peyronie's Fibromatosis
Portuguese DOENCA DE PEYRONIE, Induração plástica do pénis, Induração do pénis, Cavernite fibrosa, Doença de La Peyronie, Cavernite Fibrosa, Doença de Peyronie, Induração Peniana
Spanish ENFERMEDAD DE PEYRONIE, Induración plástica del pene, Enferemedad de Peyronie, Cavenitis fibrosa, Endurecimiento peniano, induración plástica del pene (trastorno), induración plástica del pene, enfermedad de Peyronie, enfermedad de Peyronie (trastorno), cavernositis fibrosa, fibromatosis peniana, Enfermedad de Peyronie, Cavernitis Fibrosa, Induración Peniana
Dutch induratio penis plastica, fibreuze cavernitis, penisinduratie, induratie; penis, penis; induratie, ziekte van Peyronie, Cavernitis, fibreuze, Induratio penis plastica, Peyronie, ziekte van
French Induration plastique du pénis, Induration pénienne, MALADIE DE LA PEYRONIE, Maladie de La peyronie, Induratio penis plastica, Induration plastique des corps caverneux du pénis, Induration plastique des corps caverneux, Maladie de La Peyronie, Sclérose des corps caverneux
German Cavernitis fibrosa, INDURATIO PENIS PLASTIKA, Induratio Penis plastica, Induratio penis plastica, Penisinduration, Sclerosis fibrosa penis, Peyronie-Krankheit, Cavernitis, fibröse
Italian Indurimento del pene, Indurimento plastico del pene, Cavernite fibrosa, Malattia di Peyronie, Fibromatosi del pene, Induratio penis plastica, Enduratio penis
Japanese 陰茎硬結, 陰茎形成硬結, ﾍﾟｲﾛﾆｰﾋﾞｮｳ, ｾﾝｲｾｲｶｲﾒﾝﾀｲｴﾝ, ｲﾝｹｲｺｳｹﾂ, ｲﾝｹｲｹｲｾｲｺｳｹﾂ, 陰茎形成性硬結, Peyronie病, ペイロニー病, 線維性海綿体炎, 陰茎成形性硬結, 陰茎整形硬化症, 陰茎硬化, 陰茎硬化症, パイロニー病, ペーロニー病, 海綿体炎-線維性
Swedish Penisinduration
Czech penis - indurace, Peyronieova choroba, Morbus Peyronie, Plastická indurace penisu, Indurace penisu, Fibrózní kavernitida
Finnish Peyronien tauti
Russian PEIRONI BOLEZN', KAVERNIT FIBROZNYI, POLOVOGO CHLENA INDURATSIIA, INDURATSIIA POLOVOGO CHLENA FIBROPLASTICHESKAIA, ИНДУРАЦИЯ ПОЛОВОГО ЧЛЕНА ФИБРОПЛАСТИЧЕСКАЯ, КАВЕРНИТ ФИБРОЗНЫЙ, ПЕЙРОНИ БОЛЕЗНЬ, ПОЛОВОГО ЧЛЕНА ИНДУРАЦИЯ
Polish Stwardnienie prącia plastyczne, Choroba Peyroniego
Hungarian Induratio penis plastica, Fibrosus cavernitis, Penis induratio, Peyronie betegség
Norwegian Peyronies sykdom, Induratio penis plastica
Derived from the NIH UMLS (Unified Medical Language System)

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