Update on the treatment of Peyronie's disease. Literature Review

Abstract

Introduction: Peyronie's disease is a progressive and localized fibrotic disorder that affects the tunica albuginea. Generally, men will present with a new curvature of the penis, which may be associated with pain in the acute phase. This pathology can also be frequently associated with erectile dysfunction, shortening of the penis, psychological distress and a palpable plaque, which is usually found on the dorsal aspect of the shaft of the penis evidenced on physical examination by the doctor. The prevalence is estimated to be 0.4 to 20%, with manifestation typically in the fifth decade of life. The underlying pathogenesis of Peyronie's disease is unknown but is likely to be multifactorial with an interplay between genetic predisposition, trauma, and tissue ischemia.
Within systemic management, the American Urological Association (AUA) does not recommend any oral pharmacotherapy due to the lack of solid evidence. In contrast, the European Association of Urology (EAU) suggests that potassium paraaminobenzoate may result in a significant reduction in curvature, plaque size, and pain. The use of antioxidant therapy with vitamin E is investigated, as well as the use of phosphodiesterase-5 inhibitors and tamoxifen.
Objective: Collect truthful information with a current approach to treatments for Peyronie's disease.
Materials and Methods: The development of the article will be based on a systematic review using scientific journals from the PubMed database, UpToDate, Springer, Nature, British Medical Journal (BMJ), Frontiers in Reproductive Health and other scientific journals with updated information as of 2018, which have been found in English and Spanish. For the search, the following terms were used: "Peyronie's disease", "complications", "treatment", "risks", "urinary tract".
Results: A bibliographic review article was prepared with updated and highly interesting information in relation to the proposed topic.
Conclusion: Peyronie's disease (PD) is a disease characterized by a curvature of the penile shaft that generally involves an area of ​​plaque or fibrosis and is preceded by very painful erections. PD is considered a disorder of wound healing in the tunica albuginea, resulting in fibrosis and scarring of the tunica albuginea. The exact etiology is not known, but several hypotheses are known. There are several options for its management, oral and systemic injectable therapies used in non-surgical treatment are widely used, however, very few of these therapies are supported by well-designed randomized trials. Intralesion injection of the plaque and surgery are invasive procedures that are also used and have good results.