Alenda O, Beley S, Ferhi K, Cour F, Chartier-Kastler E, Haertig A, Richard F, Rouprêt M
Services d'urologie de la Pitié-Salpêtrière et de l'hôpital Tenon, Assistance publique-Hôpitaux de Paris, groupe hospitalo-universitaire Est, faculté de médecine Pierre-et-Marie-Curie, université Paris-VI, Paris, France.
Prog Urol. 2010 Feb;20(2):91-100. doi: 10.1016/j.purol.2009.05.010. Epub 2009 Jul 3.
Peyronie's disease (PD) is due to a fibrotic plaque forms in the tunica albuginea layer of the penis. It is responsible of penile pain, angulation, and erectile dysfunction. Even though the aetiology remains unknown, the knowledge of the pathophysiology has evolved in recent years. Recent studies indicate that PD has prevalence of 3 to 9% in adult men. During the initial acute phase (6 to 18 months), the condition may progress, stabilize or regress in 20%. Therefore, a conservative treatment approach has been advocated. An initial discussion about evaluation, information, and reassurance is necessary in most cases. The most commonly employed oral therapies include tocopherol (vitamin E), and para-aminobenzoate (Potaba), which have failed to demonstrate efficiency. Intralesional injection therapies with interferon alpha-2B, verapamil are frequently used as a first-line treatment modality, and can provide an improvement in decreasing penile pain and penile curvature. Current literature has shown that extracorporeal shock wave lithotripsy was only active on the pain. Regarding penile curvature, there are discrepancies in the published series. The surgical approach is restricted to men unresponsive to nonoperative therapies (i.e., 10% of patients). In such cases, plication, grafting or even penile prosthesis implantation are conceivable management options.
佩罗尼氏病（PD）是由于阴茎白膜层形成纤维化斑块所致。它会导致阴茎疼痛、弯曲和勃起功能障碍。尽管病因尚不清楚，但近年来对其病理生理学的认识有所发展。最近的研究表明，PD在成年男性中的患病率为3%至9%。在最初的急性期（6至18个月），病情可能进展、稳定或20%的患者病情会缓解。因此，一直提倡采用保守治疗方法。在大多数情况下，有必要就评估、信息告知和安抚患者进行初步讨论。最常用的口服疗法包括生育酚（维生素E）和对氨基苯甲酸（Potaba），但这些疗法尚未证明有效。干扰素α-2B、维拉帕米的病灶内注射疗法经常被用作一线治疗方式，并且在减轻阴茎疼痛和阴茎弯曲方面可以带来改善。目前的文献表明，体外冲击波碎石术仅对疼痛有效。关于阴茎弯曲，已发表的系列研究结果存在差异。手术方法仅限于对非手术疗法无反应的男性（即10%的患者）。在这种情况下，折叠术、移植术甚至阴茎假体植入术都是可行的治疗选择。
