An Analysis of the Natural History of Peyronie’s Disease

Mulhall, John P.; Schiff, Jonathan D.; Guhring, Patricia

doi:10.1016/s0022-5347(06)00270-9

Cited by 323 publications

(285 citation statements)

References 13 publications

Supporting

Mentioning

252

Contrasting

Unclassified

Order By: Relevance

“…Mulhall et al 6 showed that in men with Peyronie's disease who had curvature, 12% showed an improvement and 40% remained stable over a mean follow-up of 14.5 months, with the mean time from symptom onset to presentation of 3.5 months (range 2-5).…”

Section: Discussionmentioning

confidence: 99%

“…Management and patient selection for penile prosthesis operations was similar in other series, where patients were offered penile prostheses as first line management of Peyronies disease with concomitant erectile dysfunction resistant to therapy. 6,19,22 There are numerous studies comparing the efficacies of various surgical techniques for the treatment of Peyronie's disease. Postoperative outcomes vary greatly with factors such as surgical competency and the quality of pre and postoperative care being largely responsible for such large discrepancies in result.…”

Section: Discussionmentioning

confidence: 99%

“…1 Assessing treatments in Peyronie's disease is difficult due to the unpredictable natural course of the disease, which can range from spontaneous disease regression in rare cases to progression with severe penile deformity. [5][6][7] Furthermore, there remains a lack of standardisation with respect to the evaluation of men with Peyronie's disease and a variety of outcome measures, both subjective and objective, have been used to measure the success of the various treatment modalities available. 5,8 In this study, we aim to identify an assessment and management algorithm using the ability to successfully perform penetrative sexual activity at presentation as a treatment arbiter.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Should assessment of penetrative sexual activity be used as the treatment arbiter in the management of Peyronie's disease?

et al. 2011

View full text Add to dashboard Cite

Peyronie's disease is an inflammatory disorder, which causes thickening of the tunica albuginea of the penis. Peyronie's disease has a variable natural history and the assessment and management of the disease has yet to be standardised. The case notes of 97 patients with a diagnosis of Peyronie's disease were retrospectively reviewed at a single tertiary referral centre. Patients who were able to achieve sexual penetrative activity to the satisfaction of both partners were managed conservatively. Patients who were unable to achieve penetrative sexual activity were given intra-cavernosal prostaglandin, with those achieving a satisfactory erection being offered appropriate surgical intervention. The mean age at presentation was 50 years (range 18-82). A total of 59 (61%) men were able to have penetrative sex at the time of presentation. Following initial conservative management, only five (8%) of this group had disease progression, which stopped them from being able to penetrate. In all 38 (39%) men who were not able to penetrate at presentation were offered surgical intervention. In all 24 (63%) of these men chose to have surgical intervention. Tunical plication resulted in the ability to penetrate in 77% of men choosing this option whereas only 46% of men undergoing autologous saphenous vein grafting were able to have penetrative sex. Assessment of penetrative sexual function is an essential component of the management of patients with Peyronie's disease. This enables appropriate counselling with respect to possible conservative management or the most appropriate surgical intervention. The majority of patients with Peyronie's disease can achieve sexual penetrative activity, many without surgical intervention.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Should assessment of penetrative sexual activity be used as the treatment arbiter in the management of Peyronie's disease?

et al. 2011

View full text Add to dashboard Cite

show abstract

“…A recent study by Mulhall et al 8 of 246 men recently diagnosed with PD and followed for 1 year without treatment demonstrated that 12% improved, 40% remained stable and 48% worsened. This is different from the commonly held belief that up to 30-40% of untreated PD will improve spontaneously.…”

Section: Natural History Of Peyronie's Diseasementioning

confidence: 99%

Peyronie's disease: a critical appraisal of current diagnosis and treatment

2008

View full text Add to dashboard Cite

Peyronie's disease is a fibrotic disorder of the tunica albuginea of the penis resulting in varying degrees of penile curvature and sexual dysfunction. Diagnosis of the disorder is made by detailed sexual history and focused physical examination. A wide range of medical treatments has been employed to treat the disorder. Verapamil treatment administered by intraplaque injection is supported by generally consistent randomized controlled trials (RCT). Some RCT evidence exists to support the use of colchicine, potaba, L-carnitine and liposomal superoxide dismutase. Future studies of medical efficacy should focus on improving RCT design, implementation and results reporting to improve the quality of evidence generated by each study. The surgical treatment of Peyronie's disease is a viable and recommended alternative for men with compromised sexual function due to severe curvature or lesions causing penile instability. The choice of corrective procedure should be tailored to each patient after a detailed evaluation of disease severity and sexual function.

show abstract

“…This group of investigators previously reported that 48% of patients had curvature progression in a no-treatment natural history observation study. 47 The first randomized, single-blind trial of intralesional verapamil was published in 1998 by Rehman et al 48 Significant improvements were noted in terms of erection [6][7][8][9][10][11][12][13][14][15][16][17][18], and all patients were treatmentnaive before entry into the study. Curvature was measured during duplex ultrasound of a pharmacologically induced erection.…”

Section: Intralesional Therapiesmentioning

confidence: 99%