We treated a patient with Peyronie's disease surgically with dermal grafttechnique described by Horton and Devine. Details of the preoperative management and surgical technique are provided. We conclude that severely afflicted patient, unresponsive to medical therapy and who is unable to perform sexual intercourse because of severe penile curvature should be considered for the dermal graft penoplasty.
Coitus ; Humans ; Male ; Penile Induration* ; Transplants*

Peyronie's disease is currently considered a wound healing disorder that presents with a fibrous inelastic scar of the tunica albuginea, which is believed to occur in genetically susceptible individuals following trauma to the penis. It is characterized by the development of a palpable scar, which in the erectile state causes a variety of deformities, erectile dysfunction and painful erections, and its pathogenesis is unclear. There are many therapeutic options and each has its advantages and disadvantages. This article outlines the advances in the recent studies of Peyronie's disease.
Humans ; Male ; Penile Induration ; diagnosis ; etiology ; therapy

Peyronie's disease is an acquired connective tissue disorder affecting the tunica albuginea of the corpus cavernosum, causing penile plaque formation and persistent scar. It typically affects males between the ages of 45 and 60 years. The exact cause of Peyronie's disease is not clear and its pathological and physiological performance is the local deposition of fibrin and collagen. Men afflicted by this disorder may present with erectile pain, penile deformity (such as penile curvature or penile shortening), psychological disorder and/or erectile dysfunction. Though many medical and surgical options have been developed for the treatment of Peyronie's disease and each has its own indications, advantages and disadvantages, none of them produces very desirable effect. The studies of traction therapy for Peyronie's disease have been gradually increased in recent years. Traction therapy can be employed as a solo therapy or a part of combination therapy, preoperative or postoperative therapy for Peyronie's disease. Recent researches show that traction therapy can prevent the progression of scar, restore the length and diameter of a short penis, reduce the curvature of the penis and improve sexual function. However, large sample, multi-center, randomized controlled studies are needed to confirm its validity for Peyronie's disease. In addition, more endeavors should be exerted at its pathogenesis in order to achieve effective prevention and cure of the disease.
Adult ; Humans ; Male ; Penile Induration ; surgery ; Traction

The incidence of Peyronie's disease has continuously increased during the last 30 years. Because of the better understanding of the basic sciences of the disease, earlier diagnosis and improved medical and surgical treatment, currently patients with Peyronie's disease have a wider range of therapeutic options and may experience a better prognosis, with only few of them in need of prosthesis surgery. This paper reviews the pathogenesis, pathology, diagnosis and treatment of Peyronie's disease.
Humans ; Male ; Penile Induration ; diagnosis ; etiology ; therapy

Peyronie's disease is characterized by localized fibrosis in the tunica albuginea of the corpus cavernosum with no confirmed etiology. We report 2 cases of Peyronie's disease, in which surgical1y corrected with the dermal graft technique. One patient is performed with the penile prosthesis be. cause of sexual impotence after correction of penile curvature.
Erectile Dysfunction ; Fibrosis ; Humans ; Male ; Penile Induration* ; Penile Prosthesis ; Transplants*

Humans ; Male ; Penile Erection ; Penile Implantation ; Penile Induration/surgery* ; Penile Prosthesis

No abstract available.
Injections, Intralesional* ; Male ; Penile Induration* ; Triamcinolone Acetonide* ; Triamcinolone* ; Verapamil*

PURPOSE: To evaluate the effects of oral Tamoxifen only versus L-Carnitine plus Tamoxifen in patients with Peyronie's disease. MATERIALS AND METHODS: All 45 patients with Peyronie's disease, diagnosed using accepted definitions, were randomized into two groups and treated for 3 months with Tamoxifen only(40 mg/day)(n=17) or a combination ofL-Carnitine(2 g/day) and Tamoxifen(40 mg/day)(n=28). A medical history was obtained, and a physical examination was performed. Plaque size, pain, erectile function(IIEF score), and penile curvature were assessed. Both before and after therapy, the differences between the 2 groups were compared using independent-sample t-test with p<0.05 considered significant. RESULTS: The mean age of the 45 patients was 52.1 years, and no severe adverse events occurred in either group. In the Tamoxifen only group, the mean decrease of plaque-length was 0.46+/-0.88 mm, and mean reduction in the pain rating scale was 0.44+/-0.53. In the L-Carnitine and Tamoxifen group, mean decrease of plaque-length was 1.57+/-0.92 mm, and mean reduction in the pain rating scale was 1.27+/-0.96. Based on IIEF scores, the improvement of erectile function was 0.88+/-0.64 in the Tamoxifen only group and 1.56+/-0.75 in the L-Carnitine and Tamoxifen group. The degree of penile curvature was also measured, and the reduction of curvature angle was 9.17+/-4.92 degrees in the Tamoxifen only group and 9.55+/-6.50 degrees in the L-Carnitine and Tamoxifen group. CONCLUSIONS: This study showed significantly greater improvements in plaque size, pain, erectile function, and curvature in patients with Peyronie's disease who were treated with L-Carnitine and Tamoxifen compared with those treated with Tamoxifen only.
Carnitine* ; Humans ; Male ; Penile Induration* ; Physical Examination ; Tamoxifen*

PURPOSE: To evaluate the characteristics of magnetic resonance (MR) images in Peyronie's disease and to assess the usefulness of post-erection penile MRI. MATERIALS AND METHODS: We retrospectively reviewed the MR images of seven patients in whom Peyronie's disease was clinically suspected. All seven underwent pre- and post-erectile MRI. After the aquisition of erectile MRI, three patients also underwent contrast-enhanced MRI. We compared image quality and the rate of detection of penile plaque between pre-erectile and post-erectile images. In three patients who underwent contrast- enhanced MRI, we assessed correlation between the contrast enhancement pattern, as seen on MRI, of the plaque and corpus cavernosa and clinical inflammatory signs such as painful erection. RESULTS: In the seven patients, all post-erectile MRI images showed localized thickening and irregularities of the tunica albuginea and the septum penis, suggesting penile plaque. On pre-erectile MRI, however, plaque was detected in five cases. In six of seven cases, plaque as seen on T2-weighted images (T2WI) showed low signal intensity similar to that of the tunica albuginea, and as seen on T1-weighted images (T1W1), a signal intensity of signal intensity similar to or similar to or slightly higher than that of the tunica albuginea. In one case, plaque showed high signal intensity on both T1WI and T2WI. On T1WI, the corpus cavernosa showed homogeneous medium-signal intensity on all pre- and post-erectile MR images. On pre-erectile T2WI, the corpus cavernosa of six patients showed heterogeneous high signal intensity, whereas on post-erectile T2WI the corpus cavernosa of all patients showed homogeneous high signal intensity. Due to the enlarged penis and homogeneous signal intensity of the corpus cavernosa, the image quality of post-erectile images was superior to that of pre-erectile imjages. The images of two of three patients who underwent contrast enhanced MRI showed strong enhancement of the plaque and adjacent corpus cavernosa, while in one case, no enhancement was noted. Independently of the enhancement pattern, these three patients had no active inflammatory clinical signs such as painful erection. CONCLUSION: In Peyronie's disease, all plaque is clearly, visualized on MRI. In terms of image quality and plaque detection, post-erectile penile MR imaging is superiou to pre-erectile imaging.
Humans ; Magnetic Resonance Imaging* ; Male ; Penile Induration* ; Penis ; Retrospective Studies

PURPOSE: Although several studies have attempted to identify a relationship between Peyronie's disease (PD) and associated comorbidites including diabetes mellitus (DM), little is known about the effect of DM on the natural history of PD. We investigated the clinical characteristics of PD patients with DM for understanding of this association. MATERIAL & METHODS: Patients with PD and DM (Group 1) and those with no DM (Group 2) were compared by age, duration of PD, size and location of the plaque, severity of the penile curvature, presence of pain on erection, and the severity of erectile dysfunction by IIEF-5 scores. RESULTS: There was no significant difference in mean age of patients, duration of PD and location of the plaque between Group 1 and Group 2, respectively. The rate of severe penile curvature (>60degrees) was more frequent in Group 1 (22.7% vs. 8.6%). Plaque size was significantly bigger in Group 1 than that of Group 2 (2.2+/-1.6 vs. 1.7+/-1.3 cm, p<0.05) and mean degree of penile curvature was significantly greater in Group 1 than Group 2 (31.4+/-8.7degrees vs. 24.9+/-6.6degrees, p<0.05). The rate of severe ED (IIEF-5 < or =11 score) was significantly greater in Group 1 (18.2% vs. 4.2%, p<0.05) but pain on erection was significantly greater in Group 2 (31.8% vs. 49.2%, p<0.05). CONCLUSIONS: These results suggest that the presence of DM in patients with PD exaggerates the severity of PD by affecting the size of the plaque, penile curvature and consequent erectile dysfunction.
Diabetes Mellitus ; Erectile Dysfunction ; Humans ; Male ; Natural History ; Penile Induration