Medical, non‐invasive, and minimally invasive treatment for Peyronie’s disease: A systematic review

Abstract

Background The treatment of Peyronie's disease (PD) remains a dilemma as the true pathogenesis of PD remains an enigma. Consequently, new molecules and therapies continue to evolve. The safety and efficacy of conservative treatment for PD have not yet established. Objectives To provide the available information of the status of conservative therapy for PD. Methods A systematic literature search was conducted using PubMed, EMBASE, and the Cochrane Library for English‐language journal articles between January 2000 and July 2019, using the terms “Conservative treatment for PD”, “medical treatment for PD”, “non‐invasive therapies for PD” and “minimally invasive therapies for PD". This systematic review was conducted in agreement with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) system. We also manually reviewed references from selected articles. The risk of bias in the included RCTs was assessed using the Cochrane Risk of Bias Assessment tool (RoB 2). Results Conservative treatment is accepted as the initial treatment step in most of the cases. This kind of therapy includes various methods of treatment such as medical, non‐invasive, and minimally invasive therapies. Ideal management of PD is not yet available. It is not possible to assess the value of treatment without well‐designed, randomized, placebo‐controlled, large‐scale clinical studies. Conclusion Optimistically, in the near future, we may witness emergence of efficacious new agents and modalities to revolutionize medical, non‐invasive, and minimally invasive treatment of this devastating condition.

Congenital penile curvature as a possible risk factor for the onset of Peyronie's disease, and psychological consequences of penile curvature

“…Depression and anxiety appear to be age-related, as their severity was shown to be higher in younger subjects. In the uro-andrological clinical practice a multidisciplinary approach with the involvement of psychologists would be desirable, in order to offer PD patients psychological support treatment, which can in turn prevent or attenuate the psychological impact of this disease, which has been defined by some eminent authors a psychologically and physically devastating disorder (55)(56)(57)(58)(59).…”

Peyronie's disease development and management in diabetic men

“…Surgical treatment is indicated in men with penile deformity that limits sexual intercourse and has been stable in the last 6 months 46 . Surgical options include tunical plication, plaque incision/excision with grafting, and penile prosthesis implantation 5,47 . Tunical plication represents the first line in surgical treatment for patients with good EF, appropriate penile length, curvature < 60° and without deformities 43 .…”

“…46 Surgical options include tunical plication, plaque incision/excision with grafting, and penile prosthesis implantation. 5,47 Tunical plication represents the first line in surgical treatment for patients with good EF, appropriate penile length, curvature < 60 • and without deformities. 43 Success rates range from 92%-99% in improving penile curvature with rare adverse events.…”