背景:Peyronie病(PD)是一种纤维化疾病,导致约3-9%的成年男性形成斑块。结缔组织积聚导致斑块形成,阴茎弯曲和缩短,在某些情况下,疼痛。在PD的活跃阶段,阴茎疼痛是一种常见的症状,通常伴随着曲率的发展。PD的治疗选择包括口服药物,局部面霜,病灶内注射,牵引力,和冲击波疗法。本文综述了活动期PD的不同治疗方案。
目的:对目前的循证治疗方法进行全面综述,专注于活动相PD。
方法:在PubMed数据库中搜索有关保守治疗的研究。我们回顾了当前治疗活动期PD的临床实践和试验,并评估了其作为治疗选择的适用性。
方法:定义用于改善急性PD男性阴茎弯曲的最新有效疗法。
结果:许多试验在治疗PD方面取得了显著的益处。许多研究的口服疗法改善了患者的预后,但是数据不够。同样,指南没有批准的局部治疗。最好的选择是病灶内注射胶原酶溶组织梭状芽孢杆菌(CCh)和干扰素-α2b。冲击波疗法不推荐用于治疗曲率,但已被证明可以改善疼痛。牵引治疗可能具有改善PD曲线和阴茎长度的作用。
结论:PD仍然是泌尿科医师面临的挑战。有证据表明,口服治疗,药物的组合产生更好的结果。冲击波疗法仍未得到证实。病灶内治疗为活跃期的改善提供了最佳证据。CCh是唯一获得FDA批准的治疗选择。阴茎牵引疗法可以改善患者的预后。BrimleySC,YafiFA,格林伯格J,etal.活跃期佩罗尼病的管理方案回顾。性医学2019年修订版;7:329-337。
BACKGROUND: Peyronie\'s disease (PD) is a fibrotic disorder that leads to plaque formation in ∼3-9% of adult men. Connective tissue buildup results in plaque formation, penile curvature and shortening, and in some cases, pain. In the active phase of PD, penile pain is a common symptom, often accompanied by progression in curvature. Treatment options for PD include oral drugs, topical cream, intralesional injections, traction, and shock wave therapy. This article reviews the different treatment options for active-phase PD.
OBJECTIVE: To provide a comprehensive
review of the current evidence-based treatments, focusing on active-phase PD.
METHODS: A PubMed database search was performed for studies on conservative therapy. We reviewed current clinical practices and trials for the treatment of active-phase PD and assessed their applicability as treatment options.
METHODS: Define the most recent and effective therapies for the improvement in penile curvature in men presenting with acute PD.
RESULTS: A number of trials have resulted in significant benefits in the treatment of PD. Many of the oral therapies studied improved patient outcomes, but the data are insufficient. Similarly, there is no approved topical therapy by guidelines. The best options are intralesional injections of collagenase Clostridium histolyticum (CCh) and interferon-α2b. Shock wave therapy is not recommended for treatment of curvature, but has been shown to improve pain. Traction therapy may have a role in improving PD curve and penile length.
CONCLUSIONS: PD remains a challenge for urologists. Evidence suggests that, for oral therapy, a combination of drugs produces better results. Shock wave therapy is still unproven. Intralesional therapy delivers the best evidence for improvement in the active phase. CCh is the only FDA-approved treatment option available. Penile traction therapy may improve patient outcomes. Brimley SC, Yafi FA, Greenberg J, et al.
Review of Management Options for Active-Phase Peyronie\'s Disease. Sex Med Rev 2019;7:329-337.