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佩罗尼氏病的保守治疗——2015年更新

[Conservative therapy of Peyronie's disease - update 2015].

作者信息

Hatzichristodoulou G

机构信息

Urologische Klinik und Poliklinik, Technische Universität München, Klinikum rechts der Isar, Ismaninger Str. 22, 81675, München, Deutschland,

出版信息

Urologe A. 2015 May;54(5):641-7. doi: 10.1007/s00120-015-3796-1.

Abstract

Peyronie's disease (PD) is a benign disease of the penis leading to development of fibrous plaques at the penile tunica albuginea. PD is a heterogeneous disease with variable constellation of symptoms (penile deviation, pain, penile shortening, erectile dysfunction). Due to lack of pathophysiological knowledge there is no causal therapy of PD. Surgical therapy still represents the gold standard for correction of penile deviation. Available conservative treatment options vary from oral medical therapy to minimally invasive treatments (e.g. iontophoresis) and invasive treatment modalities (e.g. intralesional therapy). A gold standard for the conservative therapy of PD does not exist due to the nonhomogeneous disease and the variable constellation of symptoms. New conservative treatment options like penile traction and also promising treatments like intralesional injection therapy with collagenase have to be further investigated and prove their efficacy in the long-term. Moreover, well-structured, standardized, randomized placebo-controlled studies have to be done for each of the treatment modalities, so that patients can be offered successful and evidence-based conservative therapies in the future.

摘要

佩罗尼氏病(PD)是一种阴茎良性疾病,会导致阴茎白膜出现纤维斑块。PD是一种异质性疾病,症状组合多样(阴茎弯曲、疼痛、阴茎缩短、勃起功能障碍)。由于缺乏病理生理学知识,目前尚无针对PD的病因治疗方法。手术治疗仍然是矫正阴茎弯曲的金标准。现有的保守治疗选择从口服药物治疗到微创治疗(如离子导入疗法)以及侵入性治疗方式(如病灶内治疗)不等。由于该疾病的异质性和症状组合的多样性,PD保守治疗的金标准并不存在。像阴茎牵引这样的新保守治疗选择以及像胶原酶病灶内注射治疗这样有前景的治疗方法都有待进一步研究,并证明其长期疗效。此外,必须针对每种治疗方式开展结构完善、标准化、随机安慰剂对照研究,以便未来能为患者提供成功且基于证据的保守治疗方法。

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