Peyronies disease Flashcards
Definition
Disorder of the penile connective tissue
Pathophysiology
Fibrous plaque formation occurs in the corpus cavernosum’s tunica albuginea. There is inflammatory thickening with fibrin deposition, increased collagen production, decreased quantity of elastic fibres and subsequent fibrosis ± calcification. This leads to penile angulation or an hourglass-like deformity with distal flaccidity. It usually affects only the erect penis. Sexual intercourse can become painfully difficult or impossible. It is thought to occur (but nobody really knows) as a result of one-off or repeated penile vascular trauma causing leakage and immunological reaction in the relatively avascular tunica albuginea.
Epidemiology
3-9% of men, most commonly seen in the 5th decade
Associated conditions
- Dupuytrens contracture
- DM
- hypertension
- lipid abnormalities
- ischaemic cardiopathy
- ED
- smoking
- XS alcohol
Presentation
- penile pain during erections
- penile angulation
- palpable fibrous plaque
Ix
History
Physical examination
Duplex ultrasonography
Treatment
External penile contraction
Vacuum devices
Medical treatment
PO: Tamoxifen, tocopherol
TO: verapamil
intralesional: verapamil, interferon
Surgical treatment:
Extracorpeal shock wave therpay
Cold steel surgery