Guillot-Tantay C, Phé V, Chartier-Kastler E, Mozer P, Bitker M-O, Rouprêt M
Service d'urologie, faculté de médecine Pierre-et-Marie-Curie, université Paris VI, CHU Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 47-83, boulevard de l'hôpital, 75651 Paris cedex 13, France.
Service d'urologie, faculté de médecine Pierre-et-Marie-Curie, université Paris VI, CHU Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 47-83, boulevard de l'hôpital, 75651 Paris cedex 13, France.
Prog Urol. 2014 Mar;24(3):203-11. doi: 10.1016/j.purol.2013.08.328. Epub 2013 Nov 22.
The aim of the current study was to provide an overview about the surgical and medical management of acquired and congenital penile's curvature.
[corrected] A systematic review of the literature was done from the PubMed database by searching the following keywords alone or in combination: Congenital penile curvature; Congenital penile deviation; Acquired penile curvature; Acquired penile deviation; Peyronie's disease.
The treatment of congenital curvature is only surgical. The most common technique is the Nesbit's technique which consists in making elliptical excisions of the tunica albuginea. There are also incison or plication procedures which are efficient as well. Acquired curvature is most of the time represented by the Peyronie's disease or is post-traumatic. Among oral treatments available, the Potaba is the only drug which has proved a significant reduction in penile plaque size. Injections of interferon and nicardipine have also shown their efficacy. Ionotophoresis and extracorporeal shock-wave therapy may be beneficial for penile pain. Other therapies (vacuum, traction devices, topical Verapamil) can be interesting but other studies are necessary to recommend them. Surgical treatment is recommended during the fibrotic phase. The most common technique is also the Nesbit's technique. In case of severe curvature (curve superior to 60°), small penis, major deformations, graft techniques can be used. Moreover, if there is a sexual dysfunction, penile prosthesis is recommended.
Other studies are necessary to prove the efficacy of most of the drugs already available in the treatment of the penile curvature. It seems to be interesting to combine the different treatments to improve the results of those therapies.
本研究的目的是概述后天性和先天性阴茎弯曲的手术及药物治疗方法。
通过在PubMed数据库中单独或组合搜索以下关键词对文献进行系统综述：先天性阴茎弯曲；先天性阴茎偏斜；后天性阴茎弯曲；后天性阴茎偏斜；佩罗尼氏病。
先天性阴茎弯曲的治疗仅采用手术方法。最常用的技术是内斯比特技术，即对白膜进行椭圆形切除。也有切开或折叠手术，效果同样良好。后天性阴茎弯曲大多由佩罗尼氏病或外伤引起。在现有的口服治疗药物中，对氨基苯甲酸钾是唯一已被证明能显著减小阴茎硬结大小的药物。注射干扰素和尼卡地平也已显示出疗效。离子导入和体外冲击波疗法可能对阴茎疼痛有益。其他疗法（真空疗法、牵引装置、局部使用维拉帕米）可能有一定价值，但还需要更多研究来推荐使用。建议在纤维化阶段进行手术治疗。最常用的技术也是内斯比特技术。对于严重弯曲（弯曲度超过60°）、阴茎短小、严重畸形的情况，可采用移植技术。此外，如果存在性功能障碍，建议植入阴茎假体。
需要更多研究来证实大多数现有药物治疗阴茎弯曲的疗效。联合不同治疗方法以提高治疗效果似乎是有意义的。
