Bal Kavenpreet Singh, Achalu Priyanka, Okene Michael O, Krug Aaron, Hsieh Tung-Chin, Mirheydar Hossein
Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, CA, USA.
University of California, Los Angeles, Los Angeles, CA, USA.
Perm J. 2025 Mar 14;29(1):43-49. doi: 10.7812/TPP/24.135. Epub 2024 Dec 6.
Peyronie's disease (PD) is a progressive fibrotic disorder of the penis that can induce pain and erectile dysfunction and has various treatment modalities, including surgical, pharmaceutical, and injection therapies.
The authors used electronic medical records from Kaiser Permanente Southern California, an integrated health care system that consists of 15 medical centers, and identified patients diagnosed with stable PD without concomitant erectile dysfunction from January 1, 2004, to December 31, 2020. Baseline characteristics between surgical and injection groups were compared using Chi-squared and Kruskal-Wallis tests. Multivariable logistic regression with adjustment of confounders was implemented to identify which variables may influence whether patients received injection or surgical therapy.
A total of 11,706 patients with PD were identified. The rate of new PD diagnosis per 100,000 patients increased by 0.37 every year, < .05. The incident rate (per 1000 eligible patients) of surgical management declined on average by 0.40 each year ( < .001), although there was an increase rate of 1.19 for injection therapy ( < .001). On multivariable modeling, patients 45-54 years of age were more likely to receive injection therapy as the primary treatment for PD (adjusted odds ratio = 2.77; = .002; confidence interval = 1.34-5.73).
This study illustrates that pentoxifylline is now more frequently used than colchicine and vitamin E as oral treatments for PD, while collagenase injection therapy is now more prevalently employed than surgical intervention as the therapeutic approach for PD.
佩罗尼氏病（PD）是一种阴茎进行性纤维化疾病，可导致疼痛和勃起功能障碍，有多种治疗方式，包括手术、药物和注射疗法。
作者使用了南加州凯撒医疗集团的电子病历，该集团是一个由15个医疗中心组成的综合医疗系统，确定了2004年1月1日至2020年12月31日期间被诊断为稳定型PD且无勃起功能障碍的患者。使用卡方检验和克鲁斯卡尔-沃利斯检验比较手术组和注射组的基线特征。实施多变量逻辑回归并调整混杂因素，以确定哪些变量可能影响患者接受注射治疗还是手术治疗。
共识别出11706例PD患者。每10万名患者中PD新诊断率每年增加0.37，P<0.05。手术治疗的发生率（每1000名符合条件的患者）平均每年下降0.40（P<0.001），而注射治疗的发生率每年增加1.19（P<0.001）。在多变量模型中，45 - 54岁的患者更有可能接受注射治疗作为PD的主要治疗方法（调整后的优势比 = 2.77；P = 0.002；置信区间 = 1.34 - 5.73）。
本研究表明，己酮可可碱作为PD的口服治疗药物，现在比秋水仙碱和维生素E更常用，而胶原酶注射疗法作为PD的治疗方法，现在比手术干预更普遍。
