Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Division of Urology, Department of Surgery, Women's College Hospital and Mount Sinai Hospital, University of Toronto, Box 19, 6th Floor 60 Murray St, Toronto, ON, M5T 3L9, Canada.
World J Urol. 2019 Jun;37(6):1035-1041. doi: 10.1007/s00345-019-02723-9. Epub 2019 Mar 11.
Peyronie's disease (PD) and testosterone deficiency (TD) impact men at the same stage of life and can ultimately contribute to erectile dysfunction. There is speculation that low levels of testosterone (T) may predispose men to penile fibrosis; however, there is no published, up-to-date review summarizing the current evidence. Therefore, we conducted a narrative review of the literature exploring the relationship between PD and TD.
A comprehensive systematic search of existing literature of five online databases from June 1990 to June 2018 examining the relationship between PD and TD was conducted. The Cochrane risk-of-bias tool for randomized trials and the risk-of-bias assessment tool for cohort studies were used to evaluate the quality of studies.
Six studies were identified (n = 675). Overall, five studies supported the link between PD and TD by demonstrating relationships in PD patients with low total T, free T, bioavailable T, greater penile curvature, and plaque development. However, one study demonstrated no connection between the conditions. The literature is restricted by small studies with methodological flaws.
There are a number of mechanisms to support the link between TD and PD. The literature on the topic is limited by small studies which are overall conflicting. The findings of this work suggest the need for larger, prospective studies to clarify the role of TD in the development, evaluation, and treatment of PD. Establishing such a relationship could change management of PD as a diagnosis of PD may encourage clinicians to evaluate a patient's testosterone levels.
佩罗尼氏病（PD）和睾酮缺乏症（TD）影响着处于同一人生阶段的男性，最终可能导致勃起功能障碍。有人推测，低水平的睾酮（T）可能使男性易患阴茎纤维化；然而，目前还没有发表的、最新的综述总结了当前的证据。因此，我们对探索 PD 与 TD 之间关系的文献进行了叙述性综述。
我们对 1990 年 6 月至 2018 年 6 月期间的五个在线数据库中的现有文献进行了全面的系统检索，以探讨 PD 与 TD 之间的关系。使用 Cochrane 随机试验风险偏倚工具和队列研究风险偏倚评估工具来评估研究质量。
共确定了 6 项研究（n=675）。总的来说，有 5 项研究通过证明 PD 患者的总 T、游离 T、生物可利用 T 水平较低、阴茎弯曲程度更大和斑块形成与 TD 之间存在关系，支持了 PD 与 TD 之间的联系。然而，有一项研究表明这两种情况之间没有联系。文献受到小样本研究和方法学缺陷的限制。
有许多机制支持 TD 和 PD 之间的联系。关于这个主题的文献受到小样本研究的限制，这些研究总体上存在冲突。这项工作的结果表明，需要进行更大规模的前瞻性研究来阐明 TD 在 PD 的发生、评估和治疗中的作用。如果确定了这种关系，可能会改变 PD 的治疗方式，因为 PD 的诊断可能会促使临床医生评估患者的睾酮水平。
