Ibrahim Ahmed, Gazzard Lauren, Alharbi Mohannad, Rompré-Brodeur Alexis, Aube Melanie, Carrier Serge
Department of Surgery, Division of Urology, McGill University Health Center, Montreal, Quebec, Canada.
Department of Surgery, Division of Urology, McGill University Health Center, Montreal, Quebec, Canada; Department of Urology, College of Medicine, Qassim University, Qassim, Saudi Arabia.
Sex Med. 2019 Dec;7(4):459-463. doi: 10.1016/j.esxm.2019.07.003. Epub 2019 Aug 21.
Currently, there are several treatment options for Peyronie disease (PD). Although surgical interventions have better reported outcomes than conservative therapy, surgery is not suitable for all patients with PD. Therefore, oral therapy for PD is still a frequently used treatment due to low cost, convenience and limited side effects. However, current literature on the efficacy of oral therapy in PD is inconclusive. Pentoxifylline and colchicine have both shown some promise though further studies are required to confirm their effectiveness.
The aim of this study was to assess the efficacy of oral therapy for PD, including pentoxifylline and colchicine, coupled with the Andropenis penile traction therapy (PTT) extender on degree of penile curvature and plaque size.
Between March 2015 and June 2018, a prospectively collected database for patients receiving oral therapy for PD (pentoxifylline and/or colchicine) was reviewed.
Collected data variables were compared at baseline and after 6 months of treatment, including degree of curvature, plaque size, and penile Doppler ultrasound parameters (peak systolic velocity, minimum diastolic velocity, and pulsatility index). PTT was applied by the patient for a total of 1 hour per day for 6 months.
A total of 46 patients were involved in this study. Mean age was 56 ± 10 years. There was a significant decrease in the degree of penile curvature after 6 months (55.8º ± 20º vs 41.4º ± 20.8º; P = .03). Likewise, the plaque size decreased significantly from 5.42 ± 2.7 to 2.42 ± 1.71 cm; P = .0001. There was a significant increase in the peak systolic velocity from 29.8 ± 10.02 to 38.2 ± 11cm/sec; P = .02, whereas no statistically significant difference could be detected regarding end diastolic velocity (M = 0.56 ± 3.1 vs 1.59; P = .415) or pulsatility index (M = 0.03; CI = -0.06 to 0.12; P = .473). Furthermore, there was no statistically significant difference in medication type of pentoxifylline or colchicine (M = 17.23; CI = -3.31 to 37.77; P = .09).
Altogether, pentoxifylline and colchicine, taken with concomitant PTT, present a potentially convenient, low cost, and effective treatment for penile curvature and plaque resulting from PD. Prospective randomized trials are still required for better evaluation of the course of PD with patients undergoing conservative management. Ibrahim A, Gazzard L, Alharbi M, et al. Evaluation of Oral Pentoxifylline, Colchicine, and Penile Traction for the Management of Peyronie's Disease. Sex Med 2019;7:459-463.
目前，佩罗尼氏病（PD）有多种治疗选择。尽管手术干预的疗效报告优于保守治疗，但手术并不适用于所有PD患者。因此，由于成本低、方便且副作用有限，PD的口服治疗仍是常用的治疗方法。然而，目前关于PD口服治疗疗效的文献尚无定论。己酮可可碱和秋水仙碱均已显示出一定前景，不过还需要进一步研究来证实它们的有效性。
本研究的目的是评估PD的口服治疗（包括己酮可可碱和秋水仙碱）联合安德罗佩尼斯阴茎牵引疗法（PTT）延长器对阴茎弯曲程度和斑块大小的疗效。
回顾了2015年3月至2018年6月期间前瞻性收集的接受PD口服治疗（己酮可可碱和/或秋水仙碱）患者的数据库。
在基线和治疗6个月后比较收集的数据变量，包括弯曲程度、斑块大小和阴茎多普勒超声参数（收缩期峰值速度、舒张末期最小速度和搏动指数）。患者每天应用PTT共1小时，持续6个月。
本研究共纳入46例患者。平均年龄为56±10岁。6个月后阴茎弯曲程度显著降低（55.8°±20°对41.4°±20.8°；P = 0.03）。同样，斑块大小从5.42±2.7显著减小至2.42±1.71 cm；P = 0.0001。收缩期峰值速度从29.8±10.02显著增加至38.2±11cm/秒；P = 0.02，而舒张末期速度（M = 0.56±3.1对1.59；P = 0.415）或搏动指数（M = 0.03；CI = -0.06至0.12；P = 0.473）无统计学显著差异。此外，己酮可可碱或秋水仙碱的用药类型无统计学显著差异（M = 17.23；CI = -3.31至37.77；P = 0.09）。
总体而言，己酮可可碱和秋水仙碱与PTT联合使用，对PD导致的阴茎弯曲和斑块是一种潜在方便、低成本且有效的治疗方法。仍需要进行前瞻性随机试验，以更好地评估接受保守治疗的PD患者的病程。易卜拉欣A、加扎德L、阿尔哈比M等。口服己酮可可碱、秋水仙碱和阴茎牵引治疗佩罗尼氏病的评估。性医学2019；7：459 - 463。
