We appreciate the commentary by Manfredi et al. on our study investigating the impact of phosphodiesterase type 5 inhibitors (PDE5is) on Peyronie’s disease (PD) in the active phase [1]. The attention devoted to non-surgical interventions in PD in recent years highlights a growing recognition of the need for effective non-invasive treatments for this condition. This increased focus may reflect a broader shift in medical practice towards holistic patient care, emphasizing options beyond surgical intervention. Despite the paucity of clinical studies, PDE5is hold promise as a viable, safe, and practical approach to managing the condition, potentially offering relief and influencing its progression [2, 3]. With their generally well-tolerated nature and favorable safety profile [4], PDE5is emerge as an appealing choice for PD management.

In our retrospective cohort study, 133 patients with PD in the active phase were included. Group 1 (n = 101) received continuous treatment with PDE5is, while Group 2 (n = 32) received no treatment. The curvature progression was recorded over a mean follow-up of approximately one year. Between the first and last observations, Group 1 exhibited a mean penile curvature change of + 0.87° (95% CI: −1.8, 3.5), whereas Group 2 experienced a larger increase of + 5.72° (95% CI: 1.4, 10). Although there was a numerical difference in curvature progression, it did not reach statistical significance (p = 0.07), and the variance was small compared to what would be considered clinically meaningful [5]. Meanwhile, Group 1 exhibited a shorter mean duration of pain of 9.1 months (SD 4.7), compared to Group 2 reporting a mean pain duration of 12.2 months (SD 6.5) (p = 0.04).

我们感谢曼弗雷迪等人的评论。我们的研究调查了 5 型磷酸二酯酶抑制剂 (PDE5is) 对活动期佩罗尼病 (PD) 的影响 [1]。近年来，人们对帕金森病非手术干预的关注突显出人们越来越认识到这种疾病需要有效的非侵入性治疗。这种关注的增加可能反映了医疗实践向整体患者护理的更广泛转变，强调手术干预之外的选择。尽管临床研究很少，但 PDE5 有望成为一种可行、安全且实用的疾病管理方法，有可能缓解病情并影响其进展 [2, 3]。凭借其普遍良好的耐受性和良好的安全性 [4]，PDE5 成为 PD 管理的一个有吸引力的选择。

在我们的回顾性队列研究中，纳入了 133 名处于活动期的 PD 患者。第 1 组 ( n  = 101) 接受 PDE5is 持续治疗，而第 2 组 ( n  = 32) 未接受任何治疗。平均随访约一年，记录曲率进展情况。在第一次和最后一次观察之间，第 1 组的平均阴茎曲率变化为 + 0.87° (95% CI: -1.8, 3.5)，而第 2 组则经历了 + 5.72° 的较大增加 (95% CI: 1.4, 10) 。尽管曲率进展存在数值差异，但未达到统计学显着性 ( p  = 0.07)，并且与临床意义相比，方差很小 [5]。同时，第 1 组的平均疼痛持续时间较短，为 9.1 个月 (SD 4.7)，而第 2 组报告的平均疼痛持续时间为 12.2 个月 (SD 6.5) ( p  = 0.04)。