Rush University Medical Center, Chicago, IL, USA.
Nat Rev Urol. 2019 Mar;16(3):172-186. doi: 10.1038/s41585-018-0117-7.
Peyronie's disease is not a rare disorder, and it can be devastating to the affected man. Although the gold-standard treatment of Peyronie's disease is surgery in the stable phase, nonoperative management is preferred by some men and is the only treatment option in the acute phase of the disease, when surgery is contraindicated. No oral or topical therapy has been shown to be efficacious when administered alone, but some evidence supports their use as part of a combination therapy regimen. Intralesional therapies, particularly collagenase clostridium histolyticum (CCH), have shown promise. Mechanical therapies can provide benefit when applied for prolonged periods of time, improving penile curvature, indentation, and even restoring length. Regardless of the modality chosen, patient counselling is paramount, as recovery of the penis to its predisease state is highly unlikely. Thus, although many options exist for nonsurgical management of Peyronie's disease, surgery remains the best option for men who desire the most reliable and rapid pathway to a functionally straight, erect penis. The goal of nonsurgical therapy should be a scientifically feasible, safe approach to prevent the progression of, or reduce, deformity and improve sexual function.
佩罗尼病并不罕见，它可能对受影响的男性造成毁灭性的打击。虽然佩罗尼病的金标准治疗方法是稳定期的手术，但一些男性更喜欢非手术治疗，而且在手术禁忌的疾病急性期，这是唯一的治疗选择。单独使用时，没有口服或局部治疗被证明是有效的，但有一些证据支持将其作为联合治疗方案的一部分使用。腔内治疗，特别是胶原酶溶组织梭菌（CCH），显示出了希望。机械治疗在长时间应用时可以提供益处，改善阴茎弯曲、凹陷，甚至恢复长度。无论选择哪种治疗方式，患者咨询都是至关重要的，因为恢复到疾病前的阴茎状态的可能性非常低。因此，尽管存在许多非手术治疗佩罗尼病的选择，但对于那些希望通过最可靠和最快的途径获得功能正常、直立的阴茎的男性来说，手术仍然是最佳选择。非手术治疗的目标应该是一种科学可行、安全的方法，以预防或减少畸形并改善性功能。
