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Electron microscopic study of the penile plaques and adjacent corpora cavernosa in Peyronie's disease
D Hirano1, Y Takimoto, T Yamamoto
1Department of Urology, Nihon University School of Medicine, Surugadai Hospital, Tokyo, Japan.
Background:
We conducted ultrastructural studies to clarify the fine structure of penile plaques and adjacent corpora cavernosa, and the causative basis for the process, in Peyronie's disease.
Methods:
Penile plaques and adjacent corpora cavernosa were obtained during surgical extirpation from 5 patients with Peyronie's disease. Control tissues from the tunica albuginea and adjacent corpora cavernosa were obtained at penile amputation from 2 patients with penile cancer. Prepared tissues were examined by using electron microscopy.
Results:
Penile plaques were composed of collagen fibrils, amorphous particulate material, and fibroblasts in all patients. In 1 of 5 patients, myofibroblasts were found in the border area between the lesion and underlying structures. Smooth-muscle cells and endothelial cells resembling myofibroblasts were noted in adjacent corpora cavernosa. In this patient, the plaque progressively enlarged, and was removed within 1 year of onset of the induration.
Conclusions:
Fibromatosis in Peyronie's disease involves both fibroblasts and myofibroblasts, which undergo sclerosis in some phase. In addition, smooth-muscle cells and endothelial cells in the adjacent corpora cavernosa may be incorporated in the fibromatosis.