Department of Urology, University of California, Irvine Health; Orange, CA, USA.
Department of Urology, University of California, Irvine Health; Orange, CA, USA.
Sex Med Rev. 2021 Jul;9(3):434-444. doi: 10.1016/j.sxmr.2020.05.003. Epub 2020 Jul 11.
Peyronie's disease (PD) is an inflammatory disorder of the tunica albuginea causing fibrotic changes including abnormal penile curvature, pain, and erectile dysfunction. Approximately 10% of PD patients will have atypical features including ventral plaques, hourglass deformities, unilateral indentations, severely shortened penile length, and multiplanar curvatures. Currently, the only intralesional treatment approved by the United States Food and Drug Administration is considered off-label for atypical PD. Furthermore, treatment of atypical PD, especially ventral plaques, is met with hesitation, in part due to potential urethral injury.
To systematically review the available literature for the safety and efficacy of intralesional injections for atypical PD.
A thorough literature search of the PubMed database was performed on manuscripts published between 1982 and 2020. Keywords included atypical Peyronie's disease, ventral plaque, hourglass deformity, and injection.
15 articles met the criteria for evaluation. Overall, 1,357 patients with PD were treated with intralesional therapy, of which 250 patients were considered to have an atypical presentation. 162 (648%) of the patients were treated with intralesional collagenase Clostridium histolyticum, 49 (19.6%) with verapamil, 29 (11.6%) with interferon alfa-2b, 5 (2.0%) with hyaluronic acid, and another 5 (2.0%) with onabotulinumtoxinA. There was only 1 reported severe adverse event (penile fracture), which was surgically repaired. There were no reports of urethral injury.
Intralesional injection treatment may be a safe alternative option for atypical PD. There is a great need for future research to closely monitor the role of intralesional therapy in this cohort. Choi EJ, Xu P, El-Khatib FM, et al. Intralesional Injection Therapy and Atypical Peyronie's Disease: A Systematic Review. Sex Med Rev 2021;9:434-444.
佩罗尼氏病（PD）是一种白膜的炎症性疾病，导致纤维化改变，包括异常的阴茎弯曲、疼痛和勃起功能障碍。大约 10%的 PD 患者会出现非典型特征，包括腹侧斑块、沙漏畸形、单侧凹陷、阴茎长度严重缩短和多平面弯曲。目前，美国食品和药物管理局批准的唯一一种腔内治疗被认为是不典型 PD 的适应证外治疗。此外，非典型 PD 的治疗，特别是腹侧斑块，存在一定的犹豫，部分原因是潜在的尿道损伤。
系统回顾现有文献，评估腔内注射治疗非典型 PD 的安全性和疗效。
对 1982 年至 2020 年期间发表的文献进行了全面的 PubMed 数据库文献检索。关键词包括非典型佩罗尼氏病、腹侧斑块、沙漏畸形和注射。
15 篇文章符合评估标准。总体上，1357 例 PD 患者接受了腔内治疗，其中 250 例被认为有非典型表现。162 例（64.8%）患者接受了腔内胶原酶 Clostridium histolyticum 治疗，49 例（19.6%）接受了维拉帕米治疗，29 例（11.6%）接受了干扰素 alfa-2b 治疗，5 例（2.0%）接受了透明质酸治疗，另有 5 例（2.0%）接受了肉毒毒素 A 治疗。只有 1 例报告严重不良事件（阴茎骨折），经手术修复。没有尿道损伤的报告。
腔内注射治疗可能是治疗非典型 PD 的一种安全替代选择。非常需要进一步的研究来密切监测腔内治疗在这一人群中的作用。Choi EJ、Xu P、El-Khatib FM 等。腔内注射治疗与非典型佩罗尼氏病：系统评价。性医学评论 2021;9:434-444.
