Acute Phase Peyronie’s Disease: Where Do We Stand?

TL;DR

Peyronie’s disease involves penile scarring and curvature, with acute phase treatment focusing on conservative options like drugs and therapies.

Contribution

The paper reviews current treatment strategies for acute phase Peyronie’s disease and highlights the need for further clinical trials.

Findings

Surgical intervention is discouraged during the acute phase due to risk of deformity progression.

Combined therapies including PDE5Is, ESWT, and PTT are currently considered optimal for acute PD.

Randomized controlled trials are needed to determine the most effective treatment for acute phase PD.

Abstract

Peyronie’s disease (PD) is a common benign condition characterized by superficial fibrosis and scar formation at the tunica albuginea of the penis, eventually leading to penile curvature. It is believed that penile micro-traumas during intercourse and subsequent activation of inflammatory processes constitute the pathogenetic basis of the disease. Routinely, PD is divided into acute and chronic phases, with pain during erection or flaccid state being the hallmark of the former. Surgical intervention should be avoided during the acute phase, as the risk of recurrence or progression of penile deformity during this stage might affect the optimal outcomes of the procedure. During this stage, many conservative treatment options have been suggested, including oral, topical, and intralesional therapies, extracorporeal shock wave therapy (ESWT), and penile traction therapy (PTT). Currently, the optimal treatment consists of a combined treatment strategy with phosphodiesterase type 5 inhibitors (PDE5Is), ESWT for pain management, PTT, and intralesional therapies. Large, well-designed randomized controlled trials (RCTs) are necessary to further elucidate the most efficient treatment option for acute phase PD.

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