Parciby disease , or fibroplastic induction of the penis ( Latin induracio penis plastica - IPP) - a disease in which the penis is bent due to progressive fibrotic changes in the protein membrane of the penis. The disease is named for the French surgeon Francois Peyroni , who described it in 1743 . Most often it affects men aged from 30 to 60-65 years.
| Peyronie's Disease | |
|---|---|
 Patient with peyronie's disease | |
| ICD-10 | N 48.6 |
| ICD-10-KM | |
| ICD-9 | 607.85 |
| ICD-9-KM | |
| OMIM | 171,000 |
| DiseasesDB | 29308 |
| MedlinePlus | 001278 |
| eMedicine | derm / 851 |
| Mesh | D010411 |
Content
Prevalence
The prevalence of Peyronie’s disease is limited. In existing publications, the prevalence ranges from 0.4% to 9%
Etiology
The etiology is unknown. The most likely cause of Peyronie's disease is considered to be recurring microtraumas of the tunica albugia. The disease begins with an acute inflammatory process, as a result of which the proliferation of fibroblast membranes, some of which differentiate into myofibroblasts, increases, deposits of collagen and fibrin increase. Continuing inflammation leads to remodeling of the connective tissue in the fibrous plaque, which can lead to the curvature of the cavernous bodies.
Risk factors for developing Peyronie’s disease are diabetes mellitus , arterial hypertension , lipid metabolism disorders, coronary heart disease , erectile dysfunction , smoking, alcohol abuse. According to the EAU, 3–39% of patients have Dupuytren contracture [3] .
Current
Two phases of the disease can be distinguished: the phase of acute inflammation and the fibrotic stage.
The stage of acute inflammation can manifest as pain in the penis at rest and painful erection, as well as the appearance of "soft" plaques and curvature of the penis.
In the fibrotic stage, a dense palpable plaque is formed, which can subsequently be calcined, which indicates stabilization of the disease.
Over time, deterioration is observed in 30-50% of patients, stabilization - in 47-67%. Spontaneous improvement occurs only in 3-13% of patients. Improvement is possible at an early stage of the disease. After the formation, and even more so the calcification of the fibrotic plaque, spontaneous improvement is very rare.
Diagnostics
The primary diagnosis is made according to the results of external examination and palpation of the penis. You can confirm the diagnosis after radiography or ultrasound of the penis, which determines the size and structure of fibrous plaques.
Clinically, the disease manifests itself by the curvature of the penis and pain during erection, up to the impossibility of sexual intercourse. About 30% of patients suffer from erectile dysfunction.
Treatment
Conservative
- Oral vitamin E, tamoxifen, potassium aminobenzoate, colchicine, etc.
- Intracavernous injections of lidaz, interferon, hydrocortisone, collagenase, lidocaine, etc.
- Physiotherapy - electrophoresis with lidaza, chemotrypsin, LOD (local negative pressure).
Operational
Surgical intervention is most often a radical excision of the fibrous plaque. Sometimes plastic is needed at the site of a defect that forms on the cavernous body. There are several ways to excise plaque: Nesbit operation, graft placement at the site of deformity, implantation of a penile prosthesis [4] .
Links
Notes
- ↑ Disease Ontology release 2019-05-13 - 2019-05-13 - 2019.
- ↑ Monarch Disease Ontology release 2018-06-29sonu - 2018-06-29 - 2018.
- ↑ Penile Curvature. EAU Cuideline, 2012
- ↑ Surgical treatment of Peyronie's disease