Peyronie's disease cell culture models: phenotypic, genotypic and functional analyses

Jp, Mulhall; Anderson, M S; Lubrano, Tina; Shankey, T. Vincent

doi:10.1038/sj.ijir.3900874

Cited by 94 publications

(64 citation statements)

References 34 publications

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“…This inflammatory response leads to unregulated extracellular matrix deposition including fibronectin and collagen, and ultimately plaque scar formation, which does not appear to undergo proper scar remodeling, leaving an inelastic segment in the involved tunica albuginea. [4][5][6][7][8][9] Although a variety of non-surgical treatments have been suggested, none offer a reliable and effective correction of the penile deformity. 10 As a result, surgery remains the gold standard treatment option, offering the most rapid and reliable treatment which will be the focus of this article.…”

mentioning

confidence: 99%

Surgery for Peyronie's disease

Levine¹,

Larsen²

2012

Asian J Androl

109

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Peyronie's disease (PD) is most simply referred to as a fibrotic wound-healing disorder of the tunica albuginea. It is both a physically and psychologically devastating disorder that causes penile deformity, curvature, hinging, narrowing and shortening, which may compromise sexual function. Although a variety of non-surgical treatments have been suggested, none to date offer a reliable and effective correction of the penile deformity. As a result, surgery remains the gold standard treatment option, offering the most rapid and reliable treatment which will be the focus of this article. We review the preoperative evaluation, surgical algorithm, graft materials and postoperative management of PD. Outcomes for tunical shortening, tunical lengthening and penile prosthesis placement for penile straightening are reviewed. Tunica albuginea plication is the preferred method of straightening for men with adequate rigidity and less severe disease defined as curvature less than 706 without narrowing/hinging. Men who have more severe, complex deformity, but maintain strong preoperative erectile function should be considered candidates for straightening with plaque incision or partial excision and grafting. Finally, for those men who have inadequate rigidity and PD, penile prosthesis placement with straightening is the best approach to address both problems. Keywords: penile prosthesis; Peyronie's disease, penile reconstruction; plaque excision and grafting; plaque incision; tunica albuginea plication INTRODUCTION Peyronie's disease (PD) is most simply referred to as a fibrotic woundhealing disorder of the tunica albuginea. It is both a physically and psychologically devastating disorder that causes penile deformity, curvature, hinging, narrowing, shortening and painful erections. 1 The perceived loss of length and girth is often more disturbing than the curvature itself, all of which can lead to moderate to severe depressive symptoms, emotional, and relationship problems. 2,3 Despite a myriad of treatment options, PD remains a considerable therapeutic dilemma due to several factors including an incomplete understanding of its etiopathophysiology and the relative paucity of randomized, placebo-controlled trials. A general explanation of this disorder, which has gained acceptance, is that PD is a disorder in which genetically susceptible individuals experience a localized response to endogenous factors such as tumor growth factor-b, which are released in response to microtrauma. This can lead to biological transformation of cells within the tunica albuginea, cell cycle dysregulation, genotypic changes and increased expression of cytokines and free radicals. This inflammatory response leads to unregulated extracellular matrix deposition including fibronectin and collagen, and ultimately plaque scar formation, which does not appear to undergo proper scar remodeling, leaving an inelastic segment in the involved tunica albuginea. [4][5][6][7][8][9] Although a variety of non-surgical treatments have been suggested, none offer a r...

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mentioning

confidence: 99%

Surgery for Peyronie's disease

Levine¹,

Larsen²

2012

Asian J Androl

109

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“…The PD has been associated with many other conditions in urologic procedures such as radical retropubic prostatectomy, cystoscopy and introduction of indwelling urethral catheters, genital or peritoneal trauma, urethritis, lipomas (18). Even atherosclerosis has been mentioned as a target area on the study of PD, due to the similarities about the pathophysiology (19), regarding the common mechanism of cell hyperproliferation, that leads to the formation of a plaque. Since none of the various treatment modalities currently available for the management of PD is able to bring healing to the patients who are affected, the researchers' attention is increasingly directed towards innovative treatment programs based on a better understanding of the pathophysiological disease.…”

Section: Discussionmentioning

confidence: 99%

Animal experimental model of Peyronie’s disease: A pilot study

Cerruto¹,

D’Elia

Molinari³

et al. 2013

Arch Ital Urol Androl

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The Peyronie's disease (PD) is an idiopathic disorder of connective tissue of the penis, that involves the tunica albuginea of the corpora cavernosa and the adjacent areolar space. A fibrous plaque replaces the elastic fibers that normally constitute the tunica albuginea, limiting its extensibility, and causing pain during erection, erectile dysfunction and difficulty of penetration, as a result of the deviation of the penis. Although it was once considered a relatively infrequent disease, some studies show that the prevalence of IPP is Results: The MRI acquisitions, both in coronal and axial projection, showed an adequate visibility of the anatomical structures. At 7 days after thrombin injection with the dartos incision it was evident an oedematous portion, visible as a hyperintense area, located at the injection area. At 21 days after injection, oedema was partially resolved: the injection part of the hyperintense area remains unchanged, while the remaining area appears to be part of a re-absorption and re-organization process. Conclusions: Since none of the various treatment modalities currently available for the management of PD is able to bring healing, the researchers' attention is increasingly directed towards innovative treatment programs, such as the use of stem cells of mesenchymal origin. At the present time, the research in PD is hampered by the lack of universally accepted animal model and this is likely attributed to the limited insight into PD mechanisms and the difficulties faced by current animal models to truly represent the complexity.

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“…33 Increased free radical expression and a prolonged inflammatory phase of wound healing has been demonstrated in PD. 4,33 In 1983, Pryor and Farell 34 conducted a double-blind, placebo-controlled crossover study evaluating vitamin E for the treatment of PD in 40 patients. No significant improvements were noted in plaque size or penile curvature.…”

Section: Carnitinementioning

confidence: 99%

“…41,42 In 1994, Levine et al 43 were the first to introduce intralesional verapamil for PD. This was the first of the three published non-randomized trials by this…”

Section: Intralesional Therapiesmentioning

confidence: 99%

“…This inflammatory response leads to unregulated extracellular matrix deposition including fibronectin and collagen, and ultimately plaque formation, which does not appear to undergo proper scar remodeling, leaving an inelastic segment in the involved tunica albuginea. [2][3][4][5][6][7][8] Del Carlo et al 9 investigated the role of matrix metalloproteinases (MMPs), the major identified antifibrotic enzymes, and tissue inhibitors of matrix metalloproteinases (TIMPs) in the pathogenesis of PD, using harvested plaque from human PD patients. PD tissue samples were found to have reduced or absent levels of MMP 1, 8 and 13, when compared with patientmatched perilesional tunica.…”

Section: Introductionmentioning

confidence: 99%

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