Peyronie's disease
| Peyronie's disease | |
|---|---|
| Other names | Peyronie disease, induratio penis plastica (IPP),[1] chronic inflammation of the tunica albuginea (CITA) |
| Man showing abnormal curvature of the penis associated with Peyronie's disease | |
| Pronunciation |
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| Specialty | Urology |
| Causes | Unknown[2] |
| Frequency | ~10% of men[2] |
| Named after | François Gigot de la Peyronie |
Peyronie's disease (PD) is a benign, acquired penile connective tissue disease characterized by the occurrence of fibrotic plaques within the tunica albuginea — the dense elastic covering of the corpora cavernosa. The plaques cause abnormal curvature, pain, penile deformities (e.g., narrowing or indentation), and usually erectile dysfunction, particularly during erection. The condition typically leads to significant sexual and psychological effects, including difficulty with penetration and lowered self-esteem or evasiveness. Peyronie's disease is most often seen in middle-aged and older men with a median age of onset between 55 and 60 years, although it has also been noted in younger individuals and adolescents.
While the etiology of PD is still a mystery, the leading hypothesis is that it arises from dysregulated wound healing in response to chronic microtrauma of the erect penis. This triggers a cascade of profibrotic molecular pathways — most notably overexpression of transforming growth factor-beta 1 (TGF-β1) — that end in fibroblast proliferation, myofibroblast differentiation, and overproduction of type I collagen. Genetic predisposition is supported by family clustering and linkage with systemic fibrosing disorders such as Dupuytren's contracture. Risk factors include age, penile injury, diabetes mellitus, and cigarette smoking.
The prevalence of PD has been projected at 3% to 9% among the general population of men increasing with age and comorbidities such as erectile dysfunction or connective tissue disease. While PD is neither infectious nor malignant, it can have disastrous implications on sexual health and quality of life. It is diagnosed mainly on the clinical presentation supplemented by penile ultrasonography if necessary. Treatment depends on the phase and severity of the disease with conservative measures (e.g., oral therapy, traction, intralesional injection) in the milder and stable forms to surgical intervention for the advanced or stable ones. The condition is named for French surgeon François Gigot de la Peyronie, who in 1743 described the condition.[2][3]
It is estimated to affect 1–20% of men.[2] The condition becomes more common with age.[2]
- ^ Freedberg, Irwin M.; Fitzpatrick, Thomas B. (2003). Fitzpatrick's dermatology in general medicine (6th ed.). New York: McGraw-Hill, Medical Pub. Division. p. 990. ISBN 978-0-07-138076-8.
- ^ a b c d e "Penile Curvature (Peyronie's Disease)". National Institute of Diabetes and Digestive and Kidney Diseases. July 2014. Retrieved 25 October 2017.
- ^ Levine, Laurence A (2010). "Peyronie's disease and erectile dysfunction: Current understanding and future direction". Indian Journal of Urology. 22 (3): 246–50. doi:10.4103/0970-1591.27633.