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Peyronie's Disease
Aka: Peyronie's Disease, Peyronie's Syndrome, Plastic Induration of the penis, Induratio Penis Plastica, Strabismus Penis
- Epidemiology
- Males aged 45 to 65 years old
- History
- Named for Italian physician to King Louis XIV of France
- Pathophysiology
- Diminished elasticity of collagen of penis
- Irregular fibrosis of the corpora cavernosa of penis
- Fibrosis of septum or sheath
- Extends into tunica albuginea
- Spares corpus cavernosum Urethra
- Associated Conditions: Dupuytren's Contracture (47%)
- Palmar Fibrosis
- Plantar Fibrosis
- Differential Diagnosis
- Tertiary SyphilisGumma
- Scleroderma
- Alcohol Abuse
- Diabetes Mellitus
- Local Trauma
- Gouty Tophi
- Symptoms
- Focal pain with Erection (50 to 66%)
- Pain resolves as inflammation subsides
- Lateral curvature of the penis during Erection
- Penis flail distal to lesion
- Signs
- Firm, nontender Plaques
- Location
- Lateral corpora cavernosa
- Dorsal over intercorporeal septum
- 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
- 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
- Management: Surgical
- Nesbit Procedure
- Plaque excision with patch grafting of defect
- References
- Degowin (1987) Diagnostic Exam, Macmillan, p. 606-7
- Fitkin (1999) Am Fam Physician 60(2): 549-52 [PubMed]