The pathophysiology of Peyronie’s disease

Abstract

ObjectiveTo review the contemporary knowledge of the pathophysiology of Peyronie’s disease (PD).MethodsMedline was searched for papers published in English from 2000 to March 2013, using the keywords ‘Peyronie’s disease’ and ‘pathophysiology’.ResultsMore than 300 relevant articles were identified for the purpose of this review. Unfortunately only a few studies had a high level of evidence, and the remaining studies were not controlled in their design. Many theories have been proposed to explain the cause of PD, but the true pathogenesis of PD remains an enigma. Identifying particular growth factors and the specific genes responsible for the induction of PD have been the ultimate goal of research over the past several decades. This would provide the means to devise a possible gene therapy for this devastating condition. We discuss present controversies and new discoveries related to the pathophysiology of this condition.ConclusionPD is one of the most puzzling diseases in urology. The pathogenesis remains uncertain and there is still controversy about the best management. The pathogenesis of PD has been explored in animal models, cell cultures and clinical trials, but the results have led to further questions. New research on the aetiology and pathogenesis of PD is needed, and which will hopefully improve the understanding and management for patients with this frustrating disease.

Laser Therapy for Peyronie’s Disease: A Randomized Control Double-Blind Pilot Study

“…To assess erectile function, the International Index of Erectile Function (IIEF-5) questionnaire was used. 20 According to the IIEF-5 questionnaire, the classes of ED were identified as follows: severe (5-7), moderate (8)(9)(10)(11), mild to moderate (12)(13)(14)(15)(16), mild (17)(18)(19)(20)(21), and normal (22)(23)(24)(25).…”

“…[10][11][12] The management of this disease has remained a therapeutic dilemma for urologists and there is no gold standard treatment. 2,13 A laser carries light energy to injured cells to stimulate the local release of nitric oxide (a vasodilator agent), to improve cellular energy by stimulating mitochondria to accelerate ATP production, to increase metabolic activity and cell growth, improving wound healing, and to reduce acute and chronic pain. 14,15 All of these laser characteristics can reverse abnormal fibrotic reaction in PD pathophysiology.…”

“…14,15 All of these laser characteristics can reverse abnormal fibrotic reaction in PD pathophysiology. 13 For the first time in 1995 Johnson et al, 16 used a lowlevel gallium-aluminum-arsenide (GaAlAs) laser to treat patients with PD. After that in 2008, Candebat Montero et al 17 evaluated the result of the management of PD with a helium-neon laser (HeNe).…”

Are Platelet Indices such as Platelet Volume, Platelet Distribution Width, and Plateletcrit Associated with Peyronie Disease?

“…Just like TGF-β1, PDGF also plays a chemotactic role for fibroblasts [10]. Intercalarily, PDGF induces fibroblast proliferation and differentiation to myofibroblasts, collagen biosynthesis, and the tissue inhibitors of matrix metalloproteinase synthesis, in addition to contributing to plaque calcification and ossification [11][12][13][14].…”

Glimpses into the molecular pathogenesis of Peyronie’s disease

“…Nonsurgical treatment options vary from oral medication to intralesional injections with Clostridium Histolyticum collagenase [3][4][5], but up till now surgical management is the standard in patients with stable disease having serious difficulties with intercourse [6]. Little is known about the molecular pathogenesis of PD [7].…”