Division of Urology, Rush University Medical Center, Chicago, Illinois, USA.
Department of Urology, Mayo Clinic, Rochester, Minnesota, USA.
Int J Urol. 2020 Jun;27(6):504-516. doi: 10.1111/iju.14230. Epub 2020 Apr 6.
Peyronie's disease is a common yet poorly understood condition characterized by penile pain, curvature, sexual dysfunction and psychological bother. Peyronie's disease represents a penile wound healing disorder, and is thought to arise from exuberant scarring in response to penile trauma in genetically predisposed men. In the absence of active treatment, the majority of men experience stable or worsening symptoms, with few reporting spontaneous resolution in penile curvature or other deformity. In contrast, penile pain improves or resolves in the majority of men. Treatment options vary based on symptom severity and stability. Several oral therapies are commonly prescribed, although to date there are no strong data to support any oral agents as monotherapy for Peyronie's disease. Other options including penile traction therapy and intralesional injections result in modest improvements for many patients, particularly when used early after symptom onset. Penile straightening through approaches, such as penile plication and plaque incision or partial excision and grafting, represent the most rapid and reliable approach to correct penile curvature once the symptoms have stabilized. Side-effects vary based on the type of surgery carried out, and include penile shortening, sensation changes and erectile dysfunction in the minority of men. In patients with drug refractory erectile dysfunction and Peyronie's disease, placement of a penile prosthesis will address both issues, and is associated with high levels of patient satisfaction. The current review provides a practical approach to the modern evaluation and management of patients presenting with Peyronie's disease.
佩罗尼氏病是一种常见但尚未被充分了解的疾病，其特征为阴茎疼痛、弯曲、性功能障碍和心理困扰。佩罗尼氏病代表一种阴茎愈合障碍，被认为是由于遗传易感性男性的阴茎创伤引起的过度瘢痕形成所致。在没有积极治疗的情况下，大多数男性的症状稳定或恶化，很少有报告表明阴茎弯曲或其他畸形自发缓解。相比之下，大多数男性的阴茎疼痛会改善或缓解。治疗方案取决于症状的严重程度和稳定性。有几种口服治疗药物，尽管迄今为止，没有强有力的数据支持任何口服药物作为佩罗尼氏病的单一疗法。其他选择包括阴茎牵引治疗和病灶内注射，对许多患者，尤其是在症状出现后早期使用时，可取得适度改善。一旦症状稳定，通过阴茎折叠术和斑块切开术或部分切除和移植术等方法来矫正阴茎弯曲，可以实现最快和最可靠的方法。根据手术类型的不同，副作用也不同，少数男性会出现阴茎缩短、感觉变化和勃起功能障碍。对于药物难治性勃起功能障碍和佩罗尼氏病患者，阴茎假体植入术可以同时解决这两个问题，并且与患者满意度高相关。本综述提供了一种实用的方法，用于评估和管理患有佩罗尼氏病的患者。
