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Abstract：
Peyronie\'s disease (PD) is a challenging clinical entity. To assist clinicians with diagnosis and management, four separate organizations have published PD guidelines over the past five years, but there remains a lack of consensus and data-driven recommendations for many aspects of diagnosis and treatment.
To compare and contrast PD guidelines, highlighting key similarities and differences among the guideline panel recommendations and identify areas for further research.
We performed an extensive review to compare and contrast diagnosis and treatment recommendations from publically available published PD guidelines from four different organizations: American Urological Association, European Association of Urology, Canadian Urologic Association, and the International Society of Sexual Medicine.
Key similarities and differences with regards to definition, evaluation, nonsurgical and surgical treatments were compared.
Points of general consensus among the guideline panels included: History is adequate for diagnosis of PD, and intracavernosal injection is a gold standard to evaluate penile deformity prior to invasive intervention. Careful counseling with shared decision-making is required prior to treatment. In general, plication and incision and/or grafting surgery is reserved for patients with preserved erectile function whereas penile prosthesis implantation is the only surgical option for PD patients with erectile dysfunction. Overall, nonsurgical treatments have inferior evidence of efficacy with these being the main area of controversy; however, all societies recognize that intralesional injections may be used. 0Further research into the pathophysiology of PD may direct novel treatments targeted towards early intervention and rigorous outcomes research may direct best practices for the surgical treatment of PD in the future.
PD is a challenging clinical entity. Direct comparison of the published PD guidelines highlights clear standards of care as well as areas where more research is needed to promote higher levels of evidence-based practice.
To our knowledge this is the first report to directly compare and contrast published guidelines pertaining to the diagnosis and management of PD. Limitations include the lack of evidence-quality review pertaining to individual guideline recommendations, although this was not the aim of this review.
We highlight consensus of major urologic societies on many aspects of work up and management of PD with notable exceptions which may guide further research. Manka MG, White LA, Yafi FA, et al. Comparing and Contrasting Peyronie\'s Disease Guidelines: Points of Consensus and Deviation. J Sex Med 2021;18:363-375.
To compare and contrast PD guidelines, highlighting key similarities and differences among the guideline panel recommendations and identify areas for further research.
We performed an extensive review to compare and contrast diagnosis and treatment recommendations from publically available published PD guidelines from four different organizations: American Urological Association, European Association of Urology, Canadian Urologic Association, and the International Society of Sexual Medicine.
Key similarities and differences with regards to definition, evaluation, nonsurgical and surgical treatments were compared.
Points of general consensus among the guideline panels included: History is adequate for diagnosis of PD, and intracavernosal injection is a gold standard to evaluate penile deformity prior to invasive intervention. Careful counseling with shared decision-making is required prior to treatment. In general, plication and incision and/or grafting surgery is reserved for patients with preserved erectile function whereas penile prosthesis implantation is the only surgical option for PD patients with erectile dysfunction. Overall, nonsurgical treatments have inferior evidence of efficacy with these being the main area of controversy; however, all societies recognize that intralesional injections may be used. 0Further research into the pathophysiology of PD may direct novel treatments targeted towards early intervention and rigorous outcomes research may direct best practices for the surgical treatment of PD in the future.
PD is a challenging clinical entity. Direct comparison of the published PD guidelines highlights clear standards of care as well as areas where more research is needed to promote higher levels of evidence-based practice.
To our knowledge this is the first report to directly compare and contrast published guidelines pertaining to the diagnosis and management of PD. Limitations include the lack of evidence-quality review pertaining to individual guideline recommendations, although this was not the aim of this review.
We highlight consensus of major urologic societies on many aspects of work up and management of PD with notable exceptions which may guide further research. Manka MG, White LA, Yafi FA, et al. Comparing and Contrasting Peyronie\'s Disease Guidelines: Points of Consensus and Deviation. J Sex Med 2021;18:363-375.
摘要：
佩罗尼病（PD）是一种具有挑战性的临床实体。协助临床医生进行诊断和管理，在过去五年中，四个独立的组织发布了PD指南，但对于诊断和治疗的许多方面仍缺乏共识和数据驱动的建议.
为了比较和对比PD指南，强调指南小组建议之间的关键异同，并确定进一步研究的领域。
我们进行了广泛的审查，以比较和对比来自四个不同组织的公开发布的PD指南的诊断和治疗建议：美国泌尿外科协会，欧洲泌尿外科协会,加拿大泌尿外科协会，和国际性医学学会。
在定义方面的主要相似之处和不同之处，评估，比较非手术和手术治疗。
指南小组之间的共识要点包括：病史足以诊断PD，海绵体内注射是侵入性干预前评估阴茎畸形的金标准。在治疗前需要仔细的咨询和共同的决策。总的来说,对于保留勃起功能的患者，保留折叠和切开和/或移植手术，而阴茎假体植入是勃起功能障碍的PD患者的唯一手术选择。总的来说,非手术治疗的疗效证据较差，这些是争议的主要领域；然而，所有社会都认识到可以使用病灶内注射。对PD病理生理学的进一步研究可能会指导针对早期干预的新治疗方法，严格的结果研究可能会指导未来PD手术治疗的最佳实践。
PD是具有挑战性的临床实体。对已发布的PD指南进行直接比较，突出了明确的护理标准以及需要更多研究以促进更高水平的循证实践的领域。
据我们所知，这是第一份直接比较和对比已发表的有关PD诊断和治疗指南的报告。局限性包括缺乏与个别指南建议相关的证据质量审查，尽管这不是这次审查的目的。
我们强调了主要泌尿外科学会在PD工作和管理的许多方面的共识，但值得注意的例外可能会指导进一步的研究。MankaMG,白色LA,YafiFA,etal.比较和对比佩罗尼的疾病指南：共识和偏离点。JSexMed2021；18：363-375。
为了比较和对比PD指南，强调指南小组建议之间的关键异同，并确定进一步研究的领域。
我们进行了广泛的审查，以比较和对比来自四个不同组织的公开发布的PD指南的诊断和治疗建议：美国泌尿外科协会，欧洲泌尿外科协会,加拿大泌尿外科协会，和国际性医学学会。
在定义方面的主要相似之处和不同之处，评估，比较非手术和手术治疗。
指南小组之间的共识要点包括：病史足以诊断PD，海绵体内注射是侵入性干预前评估阴茎畸形的金标准。在治疗前需要仔细的咨询和共同的决策。总的来说,对于保留勃起功能的患者，保留折叠和切开和/或移植手术，而阴茎假体植入是勃起功能障碍的PD患者的唯一手术选择。总的来说,非手术治疗的疗效证据较差，这些是争议的主要领域；然而，所有社会都认识到可以使用病灶内注射。对PD病理生理学的进一步研究可能会指导针对早期干预的新治疗方法，严格的结果研究可能会指导未来PD手术治疗的最佳实践。
PD是具有挑战性的临床实体。对已发布的PD指南进行直接比较，突出了明确的护理标准以及需要更多研究以促进更高水平的循证实践的领域。
据我们所知，这是第一份直接比较和对比已发表的有关PD诊断和治疗指南的报告。局限性包括缺乏与个别指南建议相关的证据质量审查，尽管这不是这次审查的目的。
我们强调了主要泌尿外科学会在PD工作和管理的许多方面的共识，但值得注意的例外可能会指导进一步的研究。MankaMG,白色LA,YafiFA,etal.比较和对比佩罗尼的疾病指南：共识和偏离点。JSexMed2021；18：363-375。
