MacDonald Landan P, Armstrong M Luke, Lehmann Kyle J, Acker Matthew R, Langille Gavin M
Department of Urology, Dalhousie University, Halifax, NS, Canada.
Department of Urology, Dalhousie University, Saint John, NB, Canada.
Can Urol Assoc J. 2020 Sep;14(9):E428-E431. doi: 10.5489/cuaj.6205.
Peyronie's disease (PD) affects approximately 0.7-11% of men and has numerous proposed treatments. Invasive management options include surgical or injectable therapy, while penile traction therapy with vacuum erection device (VED) represents a non-invasive approach. Our objective is to assess outcomes for patients with PD who opt for non-invasive management.
We performed a retrospective analysis for patients with PD who were followed for at least three months and opted for noninvasive therapy. All patients were instructed to initiate VED traction therapy for 10 minutes twice per day. Patients were assessed for degree of PD deformity and erectile function (Sexual Health Inventory for Men [SHIM] score) at initial and subsequent encounters.
Fifty-three patients met the inclusion criteria. The mean (standard deviation [SD]) age was 57 (12) years, and the mean (SD) duration of PD prior to assessment was 25 (15) months. The mean (SD) duration of followup was 14 (11) months. Among untreated patients who did not use a VED, nine showed improvement, 20 remained stable, and four had worsening curvature. The untreated group had a significant change in curvature, with a mean improvement (SD) of 3.6 (12)° (p=0.048). All 20 men who initiated VED traction therapy had an improvement in curvature with a significant mean (SD) improvement of 23 (16)° (p=2.6×10). Changes in SHIM scores did vary significantly between groups. No complications were noted.
In patients who opt for non-invasive management of PD, VED traction therapy provides improved curvature resolution compared to those who do not use such a device. The limitations of this study include the retrospective nature and a small sample size at a single treatment center.
佩罗尼氏病（PD）影响约0.7 - 11%的男性，且有众多已提出的治疗方法。侵入性治疗方案包括手术或注射疗法，而使用真空勃起装置（VED）的阴茎牵引疗法是一种非侵入性方法。我们的目的是评估选择非侵入性治疗的PD患者的治疗效果。
我们对随访至少三个月且选择非侵入性治疗的PD患者进行了回顾性分析。所有患者均被指示开始使用VED进行牵引治疗，每天两次，每次10分钟。在初次及后续就诊时对患者的PD畸形程度和勃起功能（男性性健康量表[SHIM]评分）进行评估。
53例患者符合纳入标准。平均（标准差[SD]）年龄为57（12）岁，评估前PD的平均（SD）病程为25（15）个月。平均（SD）随访时间为14（11）个月。在未使用VED的未治疗患者中，9例病情改善，20例病情稳定，4例弯曲度恶化。未治疗组的弯曲度有显著变化，平均改善（SD）为3.6（12）°（p = 0.048）。所有开始使用VED牵引治疗的20名男性弯曲度均有改善，平均（SD）显著改善23（16）°（p = 2.6×10）。两组之间SHIM评分的变化确实存在显著差异。未观察到并发症。
在选择PD非侵入性治疗的患者中，与未使用该装置的患者相比，VED牵引治疗能更好地改善弯曲度。本研究的局限性包括其回顾性性质以及单个治疗中心的样本量较小。
