eMedicine Specialties > Urology > Common Problems of the Penis

Peyronie Disease: Follow-up

Author: Eli Lizza, MD, Clinical Instructor, Department of Urology, Weill Medical College of Cornell University
Contributor Information and Disclosures

Updated: Dec 7, 2009

Outcome and Prognosis

In general, the outcome of treatment can be judged in 2 ways, (1) by the degree of improvement in penile curvature and plaque and (2) by the return to satisfactory sexual functioning. These are mutually exclusive endpoints. Either may be the primary goal of an individual patient. The most satisfying results are obtained when the primary goal of the patient is identified early in the course of treatment. The prognosis for achieving these goals is very good if all of the potential interventions listed are included.

The most recent available data have identified some new trends in the treatment of Peyronie disease (PD), as follows:

  • When oral treatments are used, a combination of colchicine and vitamin E appears most likely to be successful.
  • Topical verapamil alone does not seem to be as effective as when it is used with EMDA to transport it into the tunica.

Some tenets of treatment remain, as follows:

  • Mild cases of PD (ie, minimal or absent pain, the ability to achieve penile erections, curvature that does not prevent intercourse) may spontaneously improve. A trial of conservative treatment with observation and reassurance is indicated.
  • Pain usually resolves with or without treatment and is not a good predictor of successful therapy.
  • Oral or topical therapy should be initiated first, especially in men with unstable plaque.
  • Indications for surgical intervention should include the following: (1) symptom duration of at least 12 months with stability in those symptoms for 3 or more months, (2) a degree of curvature and/or narrowing that interferes with sexual penetration, (3) an assessment of concurrent ED and of preoperative penile length and curvature, (4) and a realistic discussion of patient expectations and likely results. The last should address the fact that the patient's penis will not return to exactly the way it was before the onset of his symptoms, no matter what intervention is taken.
  • Consider penile plication when the erectile function is good, the curvature is simple and 60° or less, and it does not have a significant hourglass or hinge-type deformity. Simple plication of the tunica without excision or plication after linear incision appears to maximize results with minimal side effects. Some loss of penile length can be anticipated. Proper patient selection and counseling are necessary to maximize postoperative satisfaction.
  • If the patient retains erectile capability but has a complex curvature or one that is greater than 60° or if he has erectile instability due to an hourglass or hinge deformity, plaque incision with graft placement should be considered.
  • When PD and ED are both present, the best therapy appears to be implantation of a penile prosthesis with modeling or, in men with extreme curvature, plaque incision with or without graft placement.

Future and Controversies

In 2000, Anderson et al developed an in vitro tissue model with fibroblasts cultured from Peyronie plaque tissue along with fibroblasts from normal tunica and foreskin as controls.98 The authors investigated the effects of the addition of various agents, including PGE1, colchicine, or verapamil at various concentrations, on the inhibition of fibroblast proliferation. In this pilot study, they found inhibition to occur at high levels of each of the agents tested. However, they also found no statistically significant proliferation rates between the plaque and the normal tunical cells, suggesting that the effect may not be selective to Peyronie disease (PD). It may be the result of the high concentrations used in the study. Nevertheless, this model holds promise as a means to develop and test new pharmacological regimens for treating PD.

Recently, there has been interest in the emotional impact of PD in the patient. While all physicians who treat men with this condition have been aware of this facet of the overall problem, it is just now starting to be investigated in a scientific manner. Rosen et al (2008) reported on the results of an expert advisory committee that developed a conceptual model for qualitative interviews in a focus-group format.99 Sixty-four men were interviewed (28 with PD, 36 controls). The investigators found qualitative evidence of profound sexual and psychological effects of PD. They have developed a structural PD outcomes questionnaire that is presently being tested and validated.

Nelson et al (2008) studied depression and distress over time in men with PD.100 They found that 48% of 92 men with PD were classified as depressed using validated tools. Further, they found that this level of depression remained constant over time from diagnosis. The authors feel that men do not appear to adjust to PD over time and should be considered for appropriate mental health screening.

Smith et al (2008) identified a very high prevalence of emotional (81%) and relationship (54%) problems in men with PD.101 These authors found that loss of penile length and an inability to have intercourse are strong predictors of these problems. Furthermore, medical and surgical intervention used to address these concerns may enhance the quality of life in men with PD.

As we continue to refine our medical and surgical interventions, we must keep in mind that the best outcomes are achieved when we treat the whole patient. Hopefully, this new area of research and new outcomes indication tool will help us to achieve this goal.

 


More on Peyronie Disease

Overview: Peyronie Disease
Workup: Peyronie Disease
Treatment: Peyronie Disease
Follow-up: Peyronie Disease
Multimedia: Peyronie Disease
References
Further Reading
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References

  1. Peyronie F de la. Sur quelques obstacles qui s'opposent a l'ejaculation naturelle de la semence. Memoires de l'Academie de Chirurgie. 1743;1:318.

  2. 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. Nov 2001;88(7):727-30. [Medline].

  3. Gelbard MK, Dorey F, James K. The natural history of Peyronie's disease. J Urol. Dec 1990;144(6):1376-9. [Medline].

  4. Carson CC. Francois Gigot de la Peyronie (1678-1747). Invest Urol. Jul 1981;19(1):62-3. [Medline].

  5. Lindsay MB, Schain DM, Grambsch P, Benson RC, Beard CM, Kurland LT. The incidence of Peyronie's disease in Rochester, Minnesota, 1950 through 1984. J Urol. Oct 1991;146(4):1007-9. [Medline].

  6. 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. Jun 2004;171(6 Pt 1):2350-3. [Medline].

  7. Usta MF, Bivalacqua TJ, Jabren GW, Myers L, Sanabria J, Sikka SC, et al. Relationship between the severity of penile curvature and the presence of comorbidities in men with Peyronie's disease. J Urol. Feb 2004;171(2 Pt 1):775-9. [Medline].

  8. El-Sakka AI. Prevalence of Peyronie's disease among patients with erectile dysfunction. Eur Urol. Mar 2006;49(3):564-9. [Medline].

  9. Bjekic MD, Vlajinac HD, Sipetic SB, Marinkovic JM. Risk factors for Peyronie's disease: a case-control study. BJU Int. Mar 2006;97(3):570-4. [Medline].

  10. Agrawal V, Ellins E, Donald A, Minhas S, Halcox J, Ralph DJ. Systemic vascular endothelial dysfunction in Peyronie's disease. J Sex Med. Nov 2008;5(11):2688-93. [Medline].

  11. Devine CJ Jr, Somers KD, Ladaga LE. Peyronie's disease: pathophysiology. Prog Clin Biol Res. 1991;370:355-8. [Medline].

  12. Luangkhot R, Rutchik S, Agarwal V, Puglia K, Bhargava G, Melman A. Collagen alterations in the corpus cavernosum of men with sexual dysfunction. J Urol. Aug 1992;148(2 Pt 1):467-71. [Medline].

  13. Chiang PH, Chiang CP, Shen MR, Huang CH, Wang CJ, Huang IY, et al. Study of the changes in collagen of the tunica albuginea in venogenic impotence and Peyronie's disease. Eur Urol. 1992;21(1):48-51. [Medline].

  14. 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. Oct 1997;158(4):1391-4. [Medline].

  15. Gonzalez-Cadavid NF, Rajfer J. Experimental models of Peyronie's disease. Implications for new therapies. J Sex Med. Feb 2009;6(2):303-13. [Medline].

  16. Devine CJ Jr, Jordan GH, Schlossberg SM. Surgery of the penis and urethra. In: Walsh PC, Retic AB, Stamey TA. Campbell's Urology. 6th ed. Philadelphia, Pa: WB Saunders; 1992:2957-3032.

  17. Erdogru T, Boz A, Koksal T, Usta MF, Yildiz A, Gungor F, et al. Penile scintigraphy with 99mTc-human immunoglobulin G: a novel method for distinguishing the unstable and stable phases of Peyronie's disease. BJU Int. Nov 2002;90(7):703-6. [Medline].

  18. Bacal V, Rumohr J, Sturm R, Lipshultz LI, Schumacher M, Grober ED. Correlation of degree of penile curvature between patient estimates and objective measures among men with Peyronie's disease. J Sex Med. Mar 2009;6(3):862-5. [Medline].

  19. Mulhall JP, Schiff J, Guhring P. An analysis of the natural history of Peyronie's disease. J Urol. Jun 2006;175(6):2115-8; discussion 2118. [Medline].

  20. Müller A, Mulhall JP. Peyronie's disease intervention trials: methodological challenges and issues. J Sex Med. Mar 2009;6(3):848-61. [Medline].

  21. Zarafonetis CJ, Horrax TM. Treatment of Peyronie's disease with potassium para-aminobenzoate (potaba). J Urol. Jun 1959;81(6):770-2. [Medline].

  22. Carson CC. Potassium para-aminobenzoate for the treatment of Peyronie's disease: is it effective?. Tech Urol. 1997;3(3):135-9. [Medline].

  23. Colletta AA, Wakefield LM, Howell FV, van Roozendaal KE, Danielpour D, Ebbs SR, et al. Anti-oestrogens induce the secretion of active transforming growth factor beta from human fetal fibroblasts. Br J Cancer. Sep 1990;62(3):405-9. [Medline].

  24. Ralph DJ, Brooks MD, Bottazzo GF, Pryor JP. The treatment of Peyronie's disease with tamoxifen. Br J Urol. Dec 1992;70(6):648-51. [Medline].

  25. Teloken C, Rhoden EL, Grazziotin TM, Ros CT, Sogari PR, Souto CA. Tamoxifen versus placebo in the treatment of Peyronie's disease. J Urol. Dec 1999;162(6):2003-5. [Medline].

  26. Fell HB, Lawrence CE, Bagga MR, Hembry RM, Reynolds JJ. The degradation of collagen in pig synovium in vitro and the effect of colchicine. Matrix. Mar 1989;9(2):116-26. [Medline].

  27. Harris ED Jr, Krane SM. Effects of colchicine on collagenase in cultures of rheumatoid synovium. Arthritis Rheum. Nov-Dec 1971;14(6):669-84. [Medline].

  28. Akkus E, Carrier S, Rehman J, Breza J, Kadioglu A, Lue TF. Is colchicine effective in Peyronie's disease? A pilot study. Urology. Aug 1994;44(2):291-5. [Medline].

  29. Levine LA. Peyronie's disease: a difficult sexual dysfunction problem. West J Med. Sep 1998;169(3):168-9. [Medline].

  30. Prieto Castro RM, Leva Vallejo ME, Regueiro Lopez JC, Anglada Curado FJ, Alvarez Kindelan J, Requena Tapia MJ, et al. Combined treatment with vitamin E and colchicine in the early stages of Peyronie's disease. BJU Int. Apr 2003;91(6):522-4. [Medline].

  31. Safarinejad MR. Therapeutic effects of colchicine in the management of Peyronie's disease: a randomized double-blind, placebo-controlled study. Int J Impot Res. Jun 2004;16(3):238-43. [Medline].

  32. Culha M, Mutlu N, Acar O, Alici B. Patient-partner satisfaction with intracavernous medication supported with oral agents in selected cases of Peyronie's disease. A ten-month follow-up study. Int Urol Nephrol. 1999;31(2):257-62. [Medline].

  33. Winter CC, Khanna R. Peyronie's disease. Results with dermo-jet injection of dexamethasone. J Urol. 1954;72:400-403.

  34. Williams G, Green NA. The non-surgical treatment of Peyronie's disease. Br J Urol. Oct 1980;52(5):392-5. [Medline].

  35. Cipollone G, Nicolai M, Mastroprimiano G, Iantorno R, Longeri D, Tenaglia R. [Betamethasone versus placebo in Peyronie's disease]. Arch Ital Urol Androl. Sep 1998;70(4):165-8. [Medline].

  36. Lamprakopoulos A, Zorzos I, Lykourinas M. The use of betamethasone and hyaluronidase injections in the treatment of Peyronie's disease. Scand J Urol Nephrol. Dec 2000;34(6):355-60. [Medline].

  37. Lee RC, Ping JA. Calcium antagonists retard extracellular matrix production in connective tissue equivalent. J Surg Res. Nov 1990;49(5):463-6. [Medline].

  38. Levine LA, Merrick PF, Lee RC. Intralesional verapamil injection for the treatment of Peyronie's disease. J Urol. Jun 1994;151(6):1522-4. [Medline].

  39. Lasser A, Vandenberg TL, Vincent MJ, Hellstrom WJ. Intraplaque verapamil injection for treatment of Peyronie's disease. J La State Med Soc. Sep 1998;150(9):431-4. [Medline].

  40. Rehman J, Benet A, Melman A. Use of intralesional verapamil to dissolve Peyronie's disease plaque: a long-term single-blind study. Urology. Apr 1998;51(4):620-6. [Medline].

  41. Cavallini G, Modenini F, Vitali G. Open preliminary randomized prospective clinical trial of efficacy and safety of three different verapamil dilutions for intraplaque therapy of Peyronie's disease. Urology. May 2007;69(5):950-4. [Medline].

  42. Riedl CR, Plas E, Engelhardt P, Daha K, Pflüger H. Iontophoresis for treatment of Peyronie's disease. J Urol. Jan 2000;163(1):95-9. [Medline].

  43. Montorsi F, Salonia A, Guazzoni G, Barbieri L, Colombo R, Brausi M, et al. Transdermal electromotive multi-drug administration for Peyronie's disease: preliminary results. J Androl. Jan-Feb 2000;21(1):85-90. [Medline].

  44. Martin DJ, Badwan K, Parker M, Mulhall JP. Transdermal application of verapamil gel to the penile shaft fails to infiltrate the tunica albuginea. J Urol. Dec 2002;168(6):2483-5. [Medline].

  45. Levine LA, Estrada CR, Shou W, Cole A. Tunica albuginea tissue analysis after electromotive drug administration. J Urol. May 2003;169(5):1775-8. [Medline].

  46. Di Stasi SM, Giannantoni A, Capelli G, Jannini EA, Virgili G, Storti L, et al. Transdermal electromotive administration of verapamil and dexamethasone for Peyronie's disease. BJU Int. Jun 2003;91(9):825-9. [Medline].

  47. Di Stasi SM, Giannantoni A, Stephen RL, Capelli G, Giurioli A, Jannini EA, et al. A prospective, randomized study using transdermal electromotive administration of verapamil and dexamethasone for Peyronie's disease. J Urol. Apr 2004;171(4):1605-8. [Medline].

  48. Wessells H. Exploring cause and effect relationships in male sexual dysfunction. J Urol. Apr 2004;171(4):1609-10. [Medline].

  49. Mirone V, Imbimbo C, Palmieri A, Fusco F. Our experience on the association of a new physical and medical therapy in patients suffering from induratio penis plastica. Eur Urol. Oct 1999;36(4):327-30. [Medline].

  50. Husain J, Lynn NN, Jones DK, Collins GN, O'Reilly PH. Extracorporeal shock wave therapy in the management of Peyronie's disease: initial experience. BJU Int. Sep 2000;86(4):466-8. [Medline].

  51. Hauck EW, Hauptmann A, Bschleipfer T, Schmelz HU, Altinkilic BM, Weidner W. Questionable efficacy of extracorporeal shock wave therapy for Peyronie's disease: results of a prospective approach. J Urol. Jan 2004;171(1):296-9. [Medline].

  52. Hauck EW, Mueller UO, Bschleipfer T, Schmelz HU, Diemer T, Weidner W. Extracorporeal shock wave therapy for Peyronie's disease: exploratory meta-analysis of clinical trials. J Urol. Feb 2004;171(2 Pt 1):740-5. [Medline].

  53. 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. [Medline].

  54. Wegner HE, Andresen R, Knipsel HH, Miller K. Treatment of Peyronie's disease with local interferon-alpha 2b. Eur Urol. 1995;28(3):236-40. [Medline].

  55. Judge IS, Wisniewski ZS. Intralesional interferon in the treatment of Peyronie's disease: a pilot study. Br J Urol. Jan 1997;79(1):40-2. [Medline].

  56. Ahuja S, Bivalacqua TJ, Case J, Vincent M, Sikka SC, Hellstrom WJ. A pilot study demonstrating clinical benefit from intralesional interferon alpha 2B in the treatment of Peyronie's disease. J Androl. Jul-Aug 1999;20(4):444-8. [Medline].

  57. Astorga R, Cantero O, Contreras D, del Rio-Martín A, Labarta-Beceiro V, Gutiérrez-Elvírez A, et al. Intralesional recombinant interferon alpha-2b in Peyronie's disease. Arch Esp Urol. Sep 2000;53(7):665-71. [Medline].

  58. Brake M, Loertzer H, Horsch R, Keller H. Treatment of Peyronie's disease with local interferon-alpha 2b. BJU Int. May 2001;87(7):654-7. [Medline].

  59. 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. Jul 2006;176(1):394-8. [Medline].

  60. Inal T, Tokatli Z, Akand M, Ozdiler E, Yaman O. Effect of intralesional interferon-alpha 2b combined with oral vitamin E for treatment of early stage Peyronie's disease: a randomized and prospective study. Urology. May 2006;67(5):1038-42. [Medline].

  61. Leslie S. Use of external vacuum devices in Peyronie's disease. Personal communication, Unpublished data. 2001.

  62. Levine LA, Newell MM. FastSize Medical Extender for the treatment of Peyronie's disease. Expert Rev Med Devices. May 2008;5(3):305-10. [Medline].

  63. Gontero P, Di Marco M, Giubilei G, Bartoletti R, Pappagallo G, Tizzani A. Use of penile extender device in the treatment of penile curvature as a result of Peyronie's disease. Results of a phase II prospective study. J Sex Med. Feb 2009;6(2):558-66. [Medline].

  64. Incrocci L, Wijnmaalen A, Slob AK, Hop WC, Levendag PC. Low-dose radiotherapy in 179 patients with Peyronie's disease: treatment outcome and current sexual functioning. Int J Radiat Oncol Biol Phys. Jul 15 2000;47(5):1353-6. [Medline].

  65. Mulhall JP, Branch J, Lubrano T, Shankey TV. Radiation increases fibrogenic cytokine expression by Peyronie's disease fibroblasts. J Urol. Jul 2003;170(1):281-4. [Medline].

  66. Greenfield JM, Lucas S, Levine LA. Factors affecting the loss of length associated with tunica albuginea plication for correction of penile curvature. J Urol. Jan 2006;175(1):238-41. [Medline].

  67. Lue TF, El-Sakka AI. Venous patch graft for Peyronie's disease. Part I: technique. J Urol. Dec 1998;160(6 Pt 1):2047-9. [Medline].

  68. El-Sakka AI, Rashwan HM, Lue TF. Venous patch graft for Peyronie's disease. Part II: outcome analysis. J Urol. Dec 1998;160(6 Pt 1):2050-3. [Medline].

  69. Devine CJ Jr, Horton CE. Surgical treatment of Peyronie's disease with a dermal graff. J Urol. Jan 1974;111(1):44-9. [Medline].

  70. Treiber U, Gilbert P. Surgical treatment of Peyronie's disease. Urol Int. 1991;47(4):240-4. [Medline].

  71. Fournier GR Jr, Lue TF, Tanagho EA. Peyronie's plaque: surgical treatment with the carbon dioxide laser and a deep dorsal vein patch graft. J Urol. May 1993;149(5 Pt 2):1321-5. [Medline].

  72. Ganabathi K, Dmochowski R, Zimmern PE, Leach GE. Peyronie's disease: surgical treatment based on penile rigidity. J Urol. Mar 1995;153(3 Pt 1):662-6. [Medline].

  73. Krishnamurti S. Penile dermal flap for defect reconstruction in Peyronie's disease: operative technique and four years' experience in 17 patients. Int J Impot Res. Dec 1995;7(4):195-208. [Medline].

  74. Yachia D, Erlich N. Bio-fragmentable anastomosis ring in urological surgery involving the gastrointestinal tract: early experience and a historical review of mechanical intestinal anastomosis. J Urol. May 1995;153(5):1426-8. [Medline].

  75. Montorsi F, Salonia A, Briganti A. Five year follow-up of plaque incision and vein grafting for Peyronie's disease. J Urol. 2004;171:331.

  76. Kadioglu A, Tefekli A, Usta M, Demirel S, Tellaloglu S. Surgical treatment of Peyronie's disease with incision and venous patch technique. Int J Impot Res. Apr 1999;11(2):75-81. [Medline].

  77. Arena F, Peracchia G, di Stefano C, Barbieri A, Cortellini P. Peyronie's disease--incision and dorsal vein grafting combined with contralateral plication in straightening the penis. Scand J Urol Nephrol. Jun 1999;33(3):181-5. [Medline].

  78. Lue TF, El-Sakka AI. Lengthening shortened penis caused by Peyronie's disease using circular venous grafting and daily stretching with a vacuum erection device. J Urol. Apr 1999;161(4):1141-4. [Medline].

  79. Kadioglu A, Akman T, Sanli O. Surgical treatment of Peyronie's disease: a critical analysis. Eur Urol. 2006;49:987-97.

  80. Essed E, Schroeder FH. New surgical treatment for Peyronie disease. Urology. Jun 1985;25(6):582-7. [Medline].

  81. Gholami SS, Lue TF. Correction of penile curvature using the 16-dot plication technique: a review of 132 patients. J Urol. May 2002;167(5):2066-9. [Medline].

  82. Egydio PH, Lucon AM, Arap S. A single relaxing incision to correct different types of penile curvature: surgical technique based on geometrical principles. BJU Int. Nov 2004;94(7):1147-57. [Medline].

  83. 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. May 2007;4(3):581-95. [Medline].

  84. Kalsi JS, Christopher N, Ralph DJ, Minhas S. Plaque incision and fascia lata grafting in the surgical management of Peyronie's disease. BJU Int. Jul 2006;98(1):110-4; discussion 114-5. [Medline].

  85. 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. Sep 2008;5(9):2221-8; discussion 2229-30. [Medline].

  86. Wilson SK, Delk JR 2nd. A new treatment for Peyronie's disease: modeling the penis over an inflatable penile prosthesis. J Urol. Oct 1994;152(4):1121-3. [Medline].

  87. Hellstrom WJ, Reddy S. Application of pericardial graft in the surgical management of Peyronie's disease. J Urol. May 2000;163(5):1445-7. [Medline].

  88. Ralph DJ. The surgical treatment of Peyronie's disease. Eur Urol. Aug 2006;50(2):196-8. [Medline].

  89. Ebbehoj J, Metz P. New operation for "krummerik" (penile curvature). Urology. Jul 1985;26(1):76-8. [Medline].

  90. van der Horst C, Martínez Portillo FJ, Melchior D, Bross S, Alken P, Juenemann KP. Polytetrafluoroethylene versus polypropylene sutures for Essed-Schroeder tunical plication. J Urol. Aug 2003;170(2 Pt 1):472-5. [Medline].

  91. Van Der Horst C, Martínez Portillo FJ, Seif C, Alken P, Juenemann KP. Treatment of penile curvature with Essed-Schröder tunical plication: aspects of quality of life from the patients' perspective. BJU Int. Jan 2004;93(1):105-8. [Medline].

  92. Hauck EW, Bschleipfer T, Diemer T, Manning M, Schroeder-Printzen I, Weidner W. Long-term results of plaque thinning with carbide burs, small incisions and venous grafting for correcting complex penile curvature in Peyronie's disease: poor results of an "ideal" approach. J Urol. May 2002;167(5):2070-3. [Medline].

  93. Hatzichristou DG, Hatzimouratidis K, Apostolidis A, Tzortzis V, Bekos A, Ioannidis E. Corporoplasty using tunica albuginea free grafts for penile curvature: surgical technique and long-term results. J Urol. Mar 2002;167(3):1367-70. [Medline].

  94. Adeniyi AA, Goorney SR, Pryor JP, Ralph DJ. The Lue procedure: an analysis of the outcome in Peyronie's disease. BJU Int. Mar 2002;89(4):404-8. [Medline].

  95. Bella AJ, Beasley KA, Obied A, Brock GB. Minimally invasive intracorporeal incision of Peyronie's plaque: initial experiences with a new technique. Urology. Oct 2006;68(4):852-7. [Medline].

  96. Montorsi F, Salonia A, Maga T, Colombo R, Cestari A, Guazzoni G, et al. Reconfiguration of the severely fibrotic penis with a penile implant. J Urol. Nov 2001;166(5):1782-6. [Medline].

  97. Mulhall JP, Ahmed A, Anderson M. Penile prosthetic surgery for Peyronie's disease: defining the need for intraoperative adjuvant maneuvers. Available at: http://www.blackwell-synergy.com/links/doi/10.1111/j.1743-6109.04046.x/full/. J Sex Med. 2004;1(3):318-21. [Full Text].

  98. Anderson MS, Shankey TV, Lubrano T, Mulhall JP. Inhibition of Peyronie's plaque fibroblast proliferation by biologic agents. Int J Impot Res. Sep 2000;12 Suppl 3:S25-31. [Medline].

  99. Rosen R, Catania J, Lue T, Althof S, Henne J, Hellstrom W, et al. Impact of Peyronie's disease on sexual and psychosocial functioning: qualitative findings in patients and controls. J Sex Med. Aug 2008;5(8):1977-84. [Medline].

  100. Nelson CJ, Diblasio C, Kendirci M, Hellstrom W, Guhring P, Mulhall JP. The chronology of depression and distress in men with Peyronie's disease. J Sex Med. Aug 2008;5(8):1985-90. [Medline].

  101. Smith JF, Walsh TJ, Conti SL, Turek P, Lue T. Risk factors for emotional and relationship problems in Peyronie's disease. J Sex Med. Sep 2008;5(9):2179-84. [Medline].

  102. Andrews HO, Al-Akraa M, Pryor JP, Ralph DJ. The Nesbit operation for Peyronie's disease: an analysis of the failures. BJU Int. May 2001;87(7):658-60. [Medline].

  103. Bennett NE, Guhring P, Mulhall JP. Intralesional verapamil prevents the progression of Peyronie's disease. Urology. Jun 2007;69(6):1181-4. [Medline].

  104. Cavallini G, Modenini F, Vitali G. Open preliminary randomized prospective clinical trial of efficacy and safety of three different verapamil dilutions for intraplaque therapy of Peyronie's disease. Urology. May 2007;69(5):950-4. [Medline].

  105. Fitch WP 3rd, Easterling WJ, Talbert RL, Bordovsky MJ, Mosier M. Topical verapamil HCl, topical trifluoperazine, and topical magnesium sulfate for the treatment of Peyronie's disease--a placebo-controlled pilot study. J Sex Med. Mar 2007;4(2):477-84. [Medline].

  106. Gholami SS, Lue TF. Peyronie's disease. Urol Clin North Am. May 2001;28(2):377-90. [Medline].

  107. Grasso M, Lania C, Blanco S, Limonta G. The natural history of Peyronie's disease. Arch Esp Urol. Apr 2007;60(3):326-31. [Medline].

  108. Hellstrom WJ, Bivalacqua TJ. Peyronie's disease: etiology, medical, and surgical therapy. J Androl. May-Jun 2000;21(3):347-54. [Medline].

  109. Medical Economics Company. Physicians' Desk Reference. 54th ed. Montvale, NJ: Medical Economics Company; 2000:1333.

  110. Montorsi F, Salonia A, Maga T, Bua L, Guazzoni G, Barbieri L, et al. Evidence based assessment of long-term results of plaque incision and vein grafting for Peyronie's disease. J Urol. Jun 2000;163(6):1704-8. [Medline].

  111. Nyberg LM Jr, Bias WB, Hochberg MC, Walsh PC. Identification of an inherited form of Peyronie's disease with autosomal dominant inheritance and association with Dupuytren's contracture and histocompatibility B7 cross-reacting antigens. J Urol. Jul 1982;128(1):48-51. [Medline].

  112. Rosen R, Catania J, Lue T, Althof S, Henne J, Hellstrom W, et al. Impact of Peyronie's disease on sexual and psychosocial functioning: qualitative findings in patients and controls. J Sex Med. Aug 2008;5(8):1977-84. [Medline].

  113. Sasso F, Gulino G, Falabella R, D'Addessi A, Sacco E, D'Onofrio A, et al. Peyronie's disease: lights and shadows. Urol Int. 2007;78(1):1-9. [Medline].

  114. Scardino PL, Scott WW. The use of tocopherols in the treatment of Peyronie's disease. Ann N Y Acad Sci. 1949;52:390-401.

  115. Smith JF, Walsh TJ, Conti SL, Turek P, Lue T. Risk factors for emotional and relationship problems in Peyronie's disease. J Sex Med. Sep 2008;5(9):2179-84. [Medline].

  116. Srirangam SJ, Manikandan R, Hussain J, Collins GN, O'Reilly PH. Long-term results of extracorporeal shockwave therapy for Peyronie's disease. J Endourol. Nov 2006;20(11):880-4. [Medline].

  117. Trost LW, Gur S, Hellstrom WJ. Pharmacological Management of Peyronie's Disease. Drugs. 2007;67(4):527-45. [Medline].

  118. Wegner HE, Andresen R, Knispel HH, Miller K. Local interferon-alpha 2b is not an effective treatment in early-stage Peyronie's disease. Eur Urol. 1997;32(2):190-3. [Medline].

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Further Reading

For further information, see Medscape’s Erectile Dysfunction Resource Center.

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Keywords

Peyronie's disease, Peyronie disease, PD, penile fibrosis, penile curvature, induratio penis plastica, erectile dysfunction, ED, Dupuytren contracture, vascular trauma, penile trauma, penis trauma, Peyronie plaque, Peyronie’s plaque, penile pain, penile angulation, decreased erectile function, penile buckling, impotence, curvature of the penis, HLA-B7

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Contributor Information and Disclosures

Author

Eli Lizza, MD, Clinical Instructor, Department of Urology, Weill Medical College of Cornell University
Eli Lizza, MD is a member of the following medical societies: American Medical Association, American Society for Reproductive Medicine, American Urological Association, and International Society for Sexual Medicine
Disclosure: Nothing to disclose.

Medical Editor

Leonard Gabriel Gomella, MD, FACS, The Bernard W Godwin Professor of Prostate Cancer Chairman, Department of Urology, Associate Director of Clinical Affairs, Kimmel Cancer Center, Thomas Jefferson University
Leonard Gabriel Gomella, MD, FACS is a member of the following medical societies: American Association for Cancer Research, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Urological Association, Sigma Xi, Society for Basic Urologic Research, Society of University Urologists, and Society of Urologic Oncology
Disclosure: GSK Consulting fee Consulting; Astra Zeneca Honoraria Speaking and teaching; Watson Pharmaceuticals Consulting fee Consulting

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

CME Editor

J Stuart Wolf Jr, MD, FACS, David A Bloom Professor of Urology, Director of Division of Minimally Invasive Urology, Department of Urology, University of Michigan
J Stuart Wolf Jr, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Catholic Medical Association, Endourological Society, Society for Urology and Engineering, Society of Laparoendoscopic Surgeons, Society of University Urologists, and Society of Urologic Oncology
Disclosure: Terumo Corporation Consulting fee Consulting; Gyrus-ACMI Honoraria Speaking and teaching

Chief Editor

Edward David Kim, MD, FACS, Professor of Surgery, Division of Urology, University of Tennessee Graduate School of Medicine; Consulting Staff, University of Tennessee Medical Center
Edward David Kim, MD, FACS is a member of the following medical societies: American College of Surgeons, American Society for Reproductive Medicine, American Society of Andrology, American Urological Association, and Tennessee Medical Association
Disclosure: Lilly Consulting fee Consulting; Astellas Consulting fee Speaking and teaching; Indevus Consulting fee Speaking and teaching

 
 
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