To test some hypotheses about risk factors for Peyronie's disease (PD).
In a case-control study, 82 patients with PD, consecutively diagnosed at the first author's institution, were compared with 246 men visiting the same institution for dermatological diseases. Univariate and multivariate logistic regression analyses were used to assess the data.
From the multivariate logistic regression analysis the risk factors for PD were: a history of genital and/or perineal injuries, transurethral prostatectomy, cystoscopy, diabetes mellitus, hypertension, lipoma, propranolol in therapy, Dupuytren's contracture in the medical history, ever having smoked, alcohol consumption, fibromatous lesions of the genital tract of the partner, and surgical intervention on the genital tract of the partner.
The results of the present study are in line with the hypothesis that, in addition to genetic predisposition, trauma of the penis and systemic vascular diseases are risk factors for PD. Smoking and alcohol consumption also seem to have some role in the development of the disease.
"The protocols to include medications have been applied to reverse, interrupt, or attenuate the underlying mechanisms with or without beneficial effects. Surgical procedures have been developed for patients who fail conservative measures and who have stable disease . EMDA is a technique using a small electric charge to deliver a medicine through the skin transdermally. "
[Show abstract][Hide abstract] ABSTRACT: Introduction. New therapies evolve for the treatment of Peyronie's disease (PD) including the application of dexamethasone and verapamil using Electro Motive Drug Administration (EMDA). Patients and Methods. Patients with PD were routinely offered Potaba, Vitamin E, tamoxifen or colchicine for 6 to 18 months and for those with no improvement, 18 applications of dexamethasone and verapamil using EMDA occurred over a 6 week period. All 30 patients receiving EMDA therapy completed a questionnaire before and after treatment. The data was collected from December 2004 to November 2009 and analysed to evaluate the effectiveness of the treatment. Results. Median age of patients was 59 (range 39-71). Curvature was the most common presenting complaint (73.3%) followed by pain (23.3%), erectile dysfunction (13.3%), and lump (13.3%). 24/30 (80%) reported an improvement in symptoms after EMDA. 16 of the responders (66.7%) had a stable plaque for at least 6 months. The patients who complained of shortening of the penis (P = 0.003) or lowered sexual desire (P = 0.024) expressed subsequently significant response to treatment. There was statistically significant (P = 0.019) improvement of penile deviation reported by responding men. Conclusion. A significant proportion of patients who received EMDA reported decreased curvature following iontophoresis. No serious adverse reactions developed.
Advances in Urology 04/2014; 2014:957013. DOI:10.1155/2014/957013
"Il est donc difficile de prédire le pronostic individuel au commencement de la maladie et d'évaluer l'efficacité d'un traitement. Seules les douleurs semblent disparaître spontanément dans les 12 à 18 mois dans la majorité des cas  . Pour cette raison, il est recommandé de proposer un traitement conservateur médical avant toute intervention chirurgicale . "
[Show abstract][Hide abstract] ABSTRACT: Peyronie's disease (PD) is due to a fibrotic plaque forms in the tunica albuginea layer of the penis. It is responsible of penile pain, angulation, and erectile dysfunction. Even though the aetiology remains unknown, the knowledge of the pathophysiology has evolved in recent years. Recent studies indicate that PD has prevalence of 3 to 9% in adult men. During the initial acute phase (6 to 18 months), the condition may progress, stabilize or regress in 20%. Therefore, a conservative treatment approach has been advocated. An initial discussion about evaluation, information, and reassurance is necessary in most cases. The most commonly employed oral therapies include tocopherol (vitamin E), and para-aminobenzoate (Potaba), which have failed to demonstrate efficiency. Intralesional injection therapies with interferon alpha-2B, verapamil are frequently used as a first-line treatment modality, and can provide an improvement in decreasing penile pain and penile curvature. Current literature has shown that extracorporeal shock wave lithotripsy was only active on the pain. Regarding penile curvature, there are discrepancies in the published series. The surgical approach is restricted to men unresponsive to nonoperative therapies (i.e., 10% of patients). In such cases, plication, grafting or even penile prosthesis implantation are conceivable management options.
Progrès en Urologie 02/2010; 20(2):91-100. DOI:10.1016/j.purol.2009.05.010 · 0.66 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This paper reports on the incidence, presentation, and aetiological factors of Peyronie's disease in a sexual centre over an 8 year period. Of approximately 13,000 male patients, 672 (5%) were diagnosed with Peyronie's disease. The mean age was 55.6 years. Presenting symptoms included penile curvature (82%), erectile dysfunction (66%), and a history of penile pain (47%). Where possible aetiological data were recorded, 37% (of 340) had been catheterised and 42% (of 257) had a history of penile trauma. Of those presenting with penile curvature, the majority (76.4%) had a dorsal curve and the commonest plaque site was the dorsal tunica albuginea. The incidence of erectile dysfunction, catheterisation, and penile trauma is higher than that reported in many studies. This is likely to be due to the specialist nature of the clinic and the variability of information in patient files.
Sexuality and Disability 05/2002; 20(2):109-116. DOI:10.1023/A:1019826310625 · 0.72 Impact Factor
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