Peyronie's disease; penile induration; bent nail syndrome; induratio penis plastica

^[1]^[2]^[3]^[4]^[5]^[6]^[7]^[8]^[9]^[10]^[11]^[12]^[13]^[14]^[15]

Introduction

Decribed by French surgeon Francois de la Peyronie in 1743

Etiology

unknown

Epidemiology

uncommon, but not rare
1-4% of men^[3]; 3-10%^[10]; 10% of men^[12]
mean age 54 years^[6]

Pathology

fibrosis of the sinusoidal spaces (tunica albuginea) of the corpora cavernosa
corporeal artery occlusion

Clinical manifestations

painful, fibrotic plaque on the dorsum of the penis
may progess to development of penile curvature & decreased rigidity of erection
penile curvature resolves or improves in 43%, remains stable in 37%, & worsens in 20%^[11]
impotence, erectile dysfunction

Complications

30% develop fibrosis in other elastic tissues, such as in hand or foot, including Dupuytren's contracture of hand
increased risk of cancer (RR=1.1), including gastric cancer (RR=1.4), testicular cancer (RR=1.4) & melanoma (RR=1.2)^[12]
erectile dysfunction^[10]

Differential diagnosis

penile fracture
- rapid penile tissue hematoma
- immediate loss of erection

Management

67% of patients with no change in deformity over time, 12% improve & 21% worsen^[6]
- improvement generally within 1 year^[10]
oral pentoxifylline may be of benefit
vitamin E 600-1000 IU QD in combination with colchicine 1 mg BID^[4]
local interferon alpha-2b injections may be useful^[5]
- not recommended due to adverse effects^[14]
collagenase clostridium histolyticum (Xiaflex) FDA-approved 2013 for local injection^[7]
surgery, Nesbit operation
- surgery that combines penile revascularization with penile corrective techniques^[13]
- indicated when plaque is calcified & patient is impotent
penile implantation

More general terms

References

↑ Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 287-88
↑ V Altebarmakian, Kaiser Permanente, Fresno CA, 1/2000
↑ ^3.0 ^3.1 Wikipedia, Peyronie's disease http://en.wikipedia.org/wiki/Peyronie%27s_disease
↑ ^4.0 ^4.1 Prieto Castro RM et al, Combining treatment with vitamin E and colchicine in the early stages of Peyronie's disease BJU Int 2003, 91:522 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12656907
↑ ^5.0 ^5.1 Trost LW et al, Pharmacological management of Peyronie's disease Drugs 2007, 67:527 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17352513
↑ ^6.0 ^6.1 ^6.2 Berookhim BM, Choi J, Alex B, Mulhall JP. Deformity stabilization and improvement in men with untreated Peyronie's disease. BJU Int. 2014 Jan;113(1):133-6. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24053665 Free Article
↑ ^7.0 ^7.1 Gelbard M, Goldstein I, Hellstrom WJ et al Clinical efficacy, safety and tolerability of collagenase clostridium histolyticum for the treatment of peyronie disease in 2 large double-blind, randomized, placebo controlled phase 3 studies. J Urol. 2013 Jul;190(1):199-207. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23376148
↑ Shaw EJ, Mitchell GC, Tan RB et al The non-surgical treatment of peyronie disease: 2013 update. World J Mens Health. 2013 Dec;31(3):183-92. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24459651 Free PMC Article
↑ Tapscott AH, Hakim LS. Office-based management of impotence and Peyronie's disease. Urol Clin North Am. 2013 Nov;40(4):521-43. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24182973
↑ ^10.0 ^10.1 ^10.2 ^10.3 Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
↑ ^11.0 ^11.1 Bassett M Untreated Penile Curvature Gets Better Over Time - Survey-based report offers insight on natural history of Peyronie's disease. https://www.medpagetoday.com/MeetingCoverage/AUA/65296
Ziegelmann M et al The natural history of untreated Peyronie's Disease: Curvature, length, and pain. American Urological Association (AUA) 2017; Abstract PD31-01.
↑ ^12.0 ^12.1 ^12.2 Brooks M Cancer Risk Elevated in Men With Peyronie's Disease. Medscape - Oct 31, 2017. https://www.medscape.com/viewarticle/887838
↑ ^13.0 ^13.1 Boggs W Alternative Surgery for Peyronie's Disease Avoids Prosthesis Implant Medscape - Jan 10, 2018. https://www.medscape.com/viewarticle/891131
↑ ^14.0 ^14.1 Schwartz B Fast Five Quiz: Penis Conditions and Disorders Medscape. Nov 29, 2022 https://reference.medscape.com/viewarticle/984322
↑ NEJM Knowledge+

[ref1-1] Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 287-88

[ref2-2] V Altebarmakian, Kaiser Permanente, Fresno CA, 1/2000

[ref3-3] 3.0 ^3.1 Wikipedia, Peyronie's disease http://en.wikipedia.org/wiki/Peyronie%27s_disease

[ref4-4] 4.0 ^4.1 Prieto Castro RM et al, Combining treatment with vitamin E and colchicine in the early stages of Peyronie's disease BJU Int 2003, 91:522 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12656907

[ref5-5] 5.0 ^5.1 Trost LW et al, Pharmacological management of Peyronie's disease Drugs 2007, 67:527 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17352513

[ref6-6] 6.0 ^6.1 ^6.2 Berookhim BM, Choi J, Alex B, Mulhall JP. Deformity stabilization and improvement in men with untreated Peyronie's disease. BJU Int. 2014 Jan;113(1):133-6. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24053665 Free Article

[ref7-7] 7.0 ^7.1 Gelbard M, Goldstein I, Hellstrom WJ et al Clinical efficacy, safety and tolerability of collagenase clostridium histolyticum for the treatment of peyronie disease in 2 large double-blind, randomized, placebo controlled phase 3 studies. J Urol. 2013 Jul;190(1):199-207. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23376148

[ref8-8] Shaw EJ, Mitchell GC, Tan RB et al The non-surgical treatment of peyronie disease: 2013 update. World J Mens Health. 2013 Dec;31(3):183-92. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24459651 Free PMC Article

[ref9-9] Tapscott AH, Hakim LS. Office-based management of impotence and Peyronie's disease. Urol Clin North Am. 2013 Nov;40(4):521-43. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24182973

[ref10-10] 10.0 ^10.1 ^10.2 ^10.3 Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022

[ref11-11] 11.0 ^11.1 Bassett M Untreated Penile Curvature Gets Better Over Time - Survey-based report offers insight on natural history of Peyronie's disease. https://www.medpagetoday.com/MeetingCoverage/AUA/65296
Ziegelmann M et al The natural history of untreated Peyronie's Disease: Curvature, length, and pain. American Urological Association (AUA) 2017; Abstract PD31-01.

[ref12-12] 12.0 ^12.1 ^12.2 Brooks M Cancer Risk Elevated in Men With Peyronie's Disease. Medscape - Oct 31, 2017. https://www.medscape.com/viewarticle/887838

[ref13-13] 13.0 ^13.1 Boggs W Alternative Surgery for Peyronie's Disease Avoids Prosthesis Implant Medscape - Jan 10, 2018. https://www.medscape.com/viewarticle/891131

[ref14-14] 14.0 ^14.1 Schwartz B Fast Five Quiz: Penis Conditions and Disorders Medscape. Nov 29, 2022 https://reference.medscape.com/viewarticle/984322

[ref15-15] NEJM Knowledge+

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Peyronie's disease; penile induration; bent nail syndrome; induratio penis plastica

Contents

Introduction

Etiology

Epidemiology

Pathology

Clinical manifestations

Complications

Differential diagnosis

Management

More general terms

References

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Peyronie's disease; penile induration; bent nail syndrome; induratio penis plastica

Introduction

Etiology

Epidemiology

Pathology

Clinical manifestations

Complications

Differential diagnosis

Management

More general terms

References

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