What is Peyronie's (Peyronie's disease) disease?

From the Guidelines

For patients with Peyronie's disease, intralesional collagenase is the recommended therapy for curvature, as it has been shown to reduce curvature by a mean of 17° in clinical trials, according to the 2015 AUA guideline 1. When considering treatment options for Peyronie's disease, it's essential to evaluate the severity and duration of symptoms.

• For patients with curvature between 30° and 90° and intact erectile function, intralesional collagenase is a viable option, as demonstrated in the IMPRESS I and II trials 1.
• The treatment protocol involves up to eight injections of 10,000 U over 24 weeks, followed by modeling performed by the clinician and at home by the patient.
• Clinicians should counsel patients about potential adverse events, including penile ecchymosis, swelling, pain, and corporal rupture, which were reported in 84.2% of patients in the collagenase groups 1.
• Intralesional interferon α-2b is also a possible treatment option, particularly for patients with stable disease, as it has been shown to reduce curvature and improve penile pain and hemodynamics in some studies 1.
• However, the effectiveness of intralesional interferon α-2b may depend on the duration of symptoms, with better results seen in patients with stable disease.
• Ultimately, the choice of treatment should be individualized based on the patient's specific condition and medical history, and clinicians should discuss the potential benefits and risks of each option with their patients.

From the Research

Definition and Causes of Peroni's Disease

• Peroni's disease, also known as Peyronie's disease, is a localized, fibrosing condition of the penis that occurs in up to 9% of men 2.
• The exact cause of Peyronie's disease is not known, but it is believed to result from a combination of genetic susceptibility and an inciting event, such as trauma 2, 3.
• The disease is characterized by the formation of a plaque or induration of the penile shaft, leading to penile curvature or deformity during erection, penile pain, and erectile dysfunction 4.

Treatment Options for Peroni's Disease

• Treatment options for Peyronie's disease include oral medications, intralesional injections, topical creams, traction therapy, and surgery 2, 3, 5, 6, 4.
• Oral medications such as para-aminobenzoate (Potaba) and tocopherol (vitamin E) have been used to treat Peyronie's disease, but their effectiveness is not well established 2, 5, 6.
• Intralesional injections with interferon-alpha-2b or collagenase clostridium histolyticum have been shown to be effective in reducing penile curvature and improving symptoms 2, 5, 6.
• Surgery is typically reserved for patients who have not responded to conservative therapy and have significant curvature or deformity that precludes intercourse 2, 3, 4.

Efficacy of Treatment Options

• The efficacy of treatment options for Peyronie's disease varies, and there is no single treatment that is effective for all patients 5, 6.
• Intralesional injections with interferon-alpha-2b or collagenase clostridium histolyticum have been shown to be effective in reducing penile curvature and improving symptoms in some patients 2, 5, 6.
• Traction therapy may also be effective in improving penile curvature and length 6.
• Shock wave therapy has been shown to improve penile pain, but its effectiveness in reducing curvature is not well established 6.