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Nonsurgical management of Peyronie's disease.
Nature Reviews Urology ( IF 12.1 ) Pub Date : 2019-03-01 , DOI: 10.1038/s41585-018-0117-7
Peter Tsambarlis 1 , Laurence A Levine 1
Affiliation  

Peyronie's disease is not a rare disorder, and it can be devastating to the affected man. Although the gold-standard treatment of Peyronie's disease is surgery in the stable phase, nonoperative management is preferred by some men and is the only treatment option in the acute phase of the disease, when surgery is contraindicated. No oral or topical therapy has been shown to be efficacious when administered alone, but some evidence supports their use as part of a combination therapy regimen. Intralesional therapies, particularly collagenase clostridium histolyticum (CCH), have shown promise. Mechanical therapies can provide benefit when applied for prolonged periods of time, improving penile curvature, indentation, and even restoring length. Regardless of the modality chosen, patient counselling is paramount, as recovery of the penis to its predisease state is highly unlikely. Thus, although many options exist for nonsurgical management of Peyronie's disease, surgery remains the best option for men who desire the most reliable and rapid pathway to a functionally straight, erect penis. The goal of nonsurgical therapy should be a scientifically feasible, safe approach to prevent the progression of, or reduce, deformity and improve sexual function.

中文翻译:

佩罗尼氏病的非手术治疗。

佩罗尼氏病并不是罕见的疾病,对患病的人可能是毁灭性的。尽管佩罗尼氏病的黄金标准疗法是在稳定期进行手术,但某些男性更倾向于非手术治疗,并且在手术禁忌的情况下,它是该病急性期的唯一治疗选择。单独使用口服或局部疗法尚无效果,但一些证据支持将其作为联合疗法的一部分。鼻内疗法,尤其是胶原酶溶组织梭状芽孢杆菌(CCH),已显示出希望。机械疗法在长时间使用时可提供益处,可改善阴茎弯曲度,压痕,甚至恢复长度。不论选择哪种方式,患者咨询都是至高无上的,因为阴茎恢复到其疾病前状态的可能性很小。因此,尽管对于佩隆尼氏病的非手术治疗存在许多选择,但是对于希望获得功能性笔直,勃起的阴茎的最可靠,最快速途径的男性,手术仍然是最佳选择。非手术治疗的目标应是科学可行,安全的方法,以预防或减少畸形的进展并改善性功能。
更新日期:2019-01-26
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