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PubMed1996

Differential therapies in various stages of penile induration.

OBJECTIVES: To evaluate the different therapies for penile induration. The results achieved in our series of 280 patients are described and the literature reviewed. METHODS: The study analyzed 2,752 cases of the literature that had been treated with Potaba, 1420 treated with radiotherapy, 117 cases treated with Orgotein injection and 93 cases that had been treated by surgery (a malleable prosthesis had been implanted 53 patients). RESULTS: In 2,752 cases of the literature that had been treated with Potaba, an improvement was seen in 60% (range 10%-82%) and the median failure rate was 40%. The overall success rate in 117 cases treated with Orgotein was 63%, with a median failure rate of 37%. In 1420 cases that had been treated with radiotherapy, the improvement and failure rates were 60% and 40%, respectively. In 93 patients that had undergone surgery, the improvement rate was 80%. Excellent results were achieved in all but 2 of the 53 patients in whom a malleable prosthesis had been implanted (infection required explantation of the prosthesis in these 2 patients). CONCLUSIONS: The importance of performing a detailed study of the plaque is underscored. A predisposition for abnormal scar tissue formation has to be considered. If surgery is indicated, the correct choice of surgical technique can achieve excellent results.

Humans↗

PubMed1982

[Value of various therapeutic procedures in penile induration].

Etiology, pathogenesis and optimal therapy of Peyronie's disease are, 240 years after its first description, still unclear. Diagnosis includes palpation, measurement and exact drawing of the mostly dorsally and laterally located penile induration, photography of erectile deviation, cavernosography and ultrasound as follow-up controls. Pathogenesis of fibrotic stimulation is related to direct local causes such as vascular lesions, microtrauma and hemorrhage and to indirect induction of plasma exudation via autoimmune mechanisms by toxins, infections and vasoactive substances. Symptomatology in 116 of our own patients included the obligatory penile scar, erectile deviation in 75%, pain during erection in 33% and difficult or impossible intercourse in 40%. Radiotherapy in 113 patients led to healing or marked improvement in 44% of cases. In 41% the disease came to a standstill and in 15% of cases symptoms became worse. An analysis of the world literature shows surprisingly a 75% improvement by vitamin E therapy and almost a 60% amelioration by p-aminobenzoic acid and corticoid injections. Favorable results of radiotherapy vary in the literature between 50 and 70%. Reports on these successful treatments include unclear and optimistic criteria in small series and the possible spontaneous standstill or regression of the disease. Indications of operation are erectile pain, impossible invagination and a high degree of penile deviation. Surgical techniques are: (1) Excision of smaller fibrotic segments followed by longitudinal suture of the corpora cavernosa; (2) symmetric and cylindrical resection of both cavernous bodies followed by a watertight reanastomosis after mobilization of the corpus spongiosum; (3) after excision of larger plaques the defect may be covered by autologous material (danger: scar formation, aneurysmatic protrusion, impotence), and (4) hydraulic or semirigid penile prostheses are an ultima ratio. Since there was a 85% improvement or standstill of the disease and little side reactions in 113 of our patients following radiotherapy we recommend it particularly in the early inflammatory phase. An operation might be indicated for patients who do not benefit from this treatment and who show above-mentioned symptoms.

4-Aminobenzoic Acid↗

PubMed1997

[Plastic penile induration].

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4-Aminobenzoic Acid↗

PubMed1990

[Prosthetic implants for penile induration].

From 1982 to 1988 we have evaluated 283 patients affected by Peyronie's disease. 81 of these complained erectile disfunction. Semirigid penile prosthesis were inserted in 38 patients with severe induratio penis plastica. Following surgery the patients were given a sexual questionnaire in order to determine whether they had realised their expectations as well as partner acceptance. Our results appear to be favourable and prosthesis insertion in selected patients with Peronie's disease seems to be the safest, most economical and best accepted choice.

Adult↗

PubMed1976