Peyronie's disease: lights and shadows.

Area of Science:

• Urology
• Andrology
• Regenerative Medicine

Background:

• Peyronie's disease (PD) is characterized by penile plaque formation, leading to pain, curvature, and erectile dysfunction.
• The exact pathogenesis of PD remains unclear, though autoimmune factors, genetics, trauma, and genital infections are implicated risk factors.

Purpose of the Study:

• To review current understanding of Peyronie's disease etiology and pathogenesis.
• To evaluate the efficacy of various medical and surgical treatment options for PD.
• To identify optimal treatment strategies based on disease severity and patient outcomes.

Main Methods:

• Literature review of randomized trials and surgical series concerning Peyronie's disease.
• Analysis of medical therapies including vitamin E, colchicine, and verapamil injections.
• Evaluation of surgical interventions such as Nesbit operation, plication, plaque incision, and penile prostheses.

Main Results:

• Medical therapies may stabilize acute PD but lack definitive efficacy.
• Extracorporeal shock wave therapy and iontophoresis are not considered first-line treatments.
• Surgical interventions show varied success; penile prostheses with graft implantation yield the best results for severe deformities and patient satisfaction.

Conclusions:

• The etiopathogenesis of Peyronie's disease requires further elucidation.
• No current medical therapy is universally effective for PD.
• Surgical treatment, particularly penile prostheses, remains the gold standard for severe PD deformities and associated erectile dysfunction.