Paulis Gianni, Cavallini Giorgio
Regina Apostolorum Hospital, Andrology Center - Albano Laziale, Rome, Italy.
Inflamm Allergy Drug Targets. 2013 Oct;12(5):341-8. doi: 10.2174/18715281113129990055.
Several studies describing the "natural history" of Peyronie's disease (PD) (Chronic Inflammation of the Tunica Albuginea-CITA) showed that untreated patients with PD seem to have spontaneous improvement. Because of these articles many physicians found to have a non-therapeutic behavior in case of PD. This paper tries to define the natural history of PD using penile dynamic duplex ultrasound evaluation in function of factors able to elicit fibrosis of the penis. Eighty-two patients have been studied, the mean time being between PD onset and diagnosis was 9.6 ± 3.8 months, mean age was 52.6 ± 10.69. Each patient underwent to two clinical assessments for PD, with a time-lag of 18.08 ± 9.2 months. Each assessment comprises: measurement of: plaque volume in cm(3) (with dynamic echocolor Doppler ultrasonography), penile curvature in degrees (with Kelami method), pain (with Pain Intensity Numerical Rating Scale/PINRS) and sexual function (with IIEF15 scale). The following clinical and laboratory assessments were carried out on each patient: body-mass index (BMI), blood pressure measurement, blood count, serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, blood sugar, glycated haemoglobin and total testosterone. We assessed whether PD plaque volume, penile deformity, pain and modify by time, in function of risk factors of fibrosis (aging, smoking habit, erectile failure, number of comorbidities, BMI, radical prostatectomy) and/or of the severity of symptoms (plaque area, penile deformity and calcifications). Qualitative-quantitative non parametric multivariate analysis has been used as statistical test. The analysis indicated that PD symptoms increase by time in the majority of the patients, and that the increase is not linked to the severity of symptoms, but to the risk factors for developing fibrosis, with the exception of age that is inversely related. PD is a progressive disease, whose progression is linked to young age and to risk factors of fibrosis.
几项描述佩罗尼氏病（PD）（白膜慢性炎症 - CITA）“自然史”的研究表明，未经治疗的PD患者似乎有自发改善的情况。由于这些文章，许多医生发现在PD病例中采取非治疗行为。本文试图通过阴茎动态双功超声评估，根据能够引发阴茎纤维化的因素来界定PD的自然史。研究了82名患者，PD发病与诊断之间的平均时间为9.6±3.8个月，平均年龄为52.6±10.69岁。每位患者接受了两次针对PD的临床评估，时间间隔为18.08±9.2个月。每次评估包括：以立方厘米（cm³）为单位测量斑块体积（采用动态回声彩色多普勒超声检查）、以度为单位测量阴茎弯曲度（采用凯拉米方法）、疼痛程度（采用疼痛强度数字评定量表/PINRS）以及性功能（采用IIEF15量表）。对每位患者进行了以下临床和实验室评估：体重指数（BMI）、血压测量、血常规、血清谷草转氨酶、血清谷丙转氨酶、血糖、糖化血红蛋白和总睾酮。我们评估了PD斑块体积、阴茎畸形、疼痛是否随时间变化，以及这些变化与纤维化风险因素（年龄、吸烟习惯、勃起功能障碍、合并症数量、BMI、根治性前列腺切除术）和/或症状严重程度（斑块面积、阴茎畸形和钙化）之间的关系。采用定性 - 定量非参数多变量分析作为统计检验方法。分析表明，大多数患者的PD症状随时间加重，且症状加重与症状严重程度无关，而是与发生纤维化的风险因素有关，但年龄除外，年龄与症状加重呈负相关。PD是一种进行性疾病，其进展与年轻以及纤维化风险因素有关。
