Department of Urology, Mayo Clinic, Rochester, MN, USA.
Department of Urology, Mayo Clinic, Rochester, MN, USA.
Sex Med Rev. 2019 Apr;7(2):338-348. doi: 10.1016/j.sxmr.2018.02.005. Epub 2018 Apr 7.
Peyronie's disease (PD) has historically been managed by at least 1 treatment, including oral supplements or medications, intralesional injections, or surgery. Adjunctive mechanical therapies also have been described, including penile traction therapy (PTT) and vacuum erection devices (VEDs), although relatively limited data are available on their use with PD.
To review and summarize the published literature on the role and efficacy of PTT and VED in men with PD.
A PubMed search was performed of all publications on PTT and VED in men with PD from inception through September 2017.
Changes in penile curvature, length, girth, erectile function, and adverse events with PTT or VED.
PTT and VED exhibit mechanisms to improve aspects of PD, although clinical outcomes data are limited. Based on current data, PTT likely has a potential role as a primary lengthening therapy (modest improvements), in curvature correction (acute phase; unclear role in chronic phase), before penile prosthesis insertion, and after surgical correction of PD. The role of PTT as a combination therapy during collagenase Clostridium histolyticum injections is unclear. Fewer and lower level-of-evidence studies are available on VEDs and suggest potential roles in curvature correction, before penile prosthesis placement, or after PD surgery. Guideline statements from the American Urological Association and International Consultation on Sexual Medicine also support the potential role of PTT and VED in managing PD.
PTT and VED represent viable therapeutic options for managing PD, with more data currently available on PTT. Because all PTT studies used a similar style of traction device, it is unclear whether results reflect outcomes of these particular devices or traction more broadly. Further studies are required to better delineate the benefits of PTT and VED, particularly in relation to other established treatments. Avant RA, Ziegelman M, Nehra A, et al. Penile Traction Therapy and Vacuum Erection Devices in Peyronie's Disease. Sex Med Rev 2019;7:338-348.
佩罗尼氏病(PD)的治疗方法至少有 1 种,包括口服补充剂或药物、病灶内注射或手术。还描述了辅助机械疗法,包括阴茎牵引疗法(PTT)和真空勃起装置(VED),尽管关于它们在 PD 中的应用的相对有限的数据。
综述和总结已发表的关于 PTT 和 VED 在 PD 男性中的作用和疗效的文献。
对从一开始到 2017 年 9 月在 PD 男性中使用 PTT 和 VED 的所有出版物进行了 PubMed 搜索。
PTT 或 VED 治疗后阴茎弯曲度、长度、周长、勃起功能和不良反应的变化。
PTT 和 VED 通过其机制改善 PD 的各个方面,尽管临床结果数据有限。基于现有数据,PTT 可能作为原发性延长治疗(适度改善)、曲率矫正(急性期;慢性期作用不明)、阴茎假体植入前和 PD 手术后有潜在作用。PTT 在胶原酶注射中的组合治疗作用尚不清楚。VED 的研究较少,且证据水平较低,提示其在曲率矫正、阴茎假体放置前或 PD 手术后有潜在作用。美国泌尿外科学会和国际性医学咨询委员会的指南声明也支持 PTT 和 VED 在治疗 PD 中的潜在作用。
PTT 和 VED 是治疗 PD 的可行治疗选择,目前 PTT 的数据更多。由于所有 PTT 研究都使用了类似的牵引装置,因此尚不清楚结果是否反映了这些特定装置或牵引的结果。需要进一步研究以更好地阐明 PTT 和 VED 的益处,特别是与其他已确立的治疗方法相关的益处。