scholarly journals Laser Therapy for Peyronie’s Disease: A Randomized Control Double-Blind Pilot Study

2019 ◽  
Vol 10 (5) ◽  
pp. S37-S42
Author(s):  
Farzad Allameh ◽  
Mohammadreza Razzaghi ◽  
Seyed Mansoor Rayegani ◽  
Morteza Fallah-Karkan ◽  
Arash Ranjbar ◽  
...  
Keyword(s):  
Erectile Function ◽  
Peyronie’S Disease ◽  
Penile Curvature ◽  
Double Blind ◽  
Intralesional Administration ◽  
Peyronie's Disease ◽  
Group 2 ◽  
No Gold Standard ◽  
Intensity Laser

Introduction: The management of Peyronie’s disease (PD) has remained a therapeutic dilemma for physicians and there is no gold standard treatment. In this paper, we decided to investigate the beneficial effect of the intralesional administration of verapamil compared with the intralesional administration of verapamil plus a low-intensity laser (LIL). Methods: Research was activated from May 2016 to May 2018 and a total of 38 men aged 18 years and older completed the investigation. The subjects were randomly divided into 2 groups. Group 1 was composed of 22 patients that were treated only by verapamil (5 mg) plus a sham laser weekly for 6 weeks, and group 2 consisted of 22 patients that received a laser, using the BTL–6000 HIGH-INTENSITY LASER 12 W machine and the same protocol of intralesional verapamil injection. The visual analogue scale (VAS) was used to evaluate pain during an erection, penile ultrasonography was used to measure plaque size, the penile curvature angle degree was measured using the photographs taken during an erection, and the International Index of Erectile Function questionnaire was used to assess erectile function. The follow-up treatment lasted for nine months, with visits performed in the 3rd and 9th months. Results: All study parameters decreased significantly after treatment in both arms, but the reduction in pain and penile curvature improvements in combination therapy revealed more significant changes in 3 months (p = .035, p=.032). Nevertheless, these improvements were not seen in the follow-up session after 9 months. Conclusion: A laser appears to be safe treatment modality in carefully-selected patients with PD. It has moderate efficacy in the short term.

scholarly journals Use of Li-ESWT, Tadalafil, and a Vacuum Device to Preserve Erectile Function in Subjects Affected by Peyronie’s Disease and Undergoing Grafting Surgery

Uro ◽  
2021 ◽  
Vol 1 (3) ◽  
pp. 187-194
Author(s):  
Francesco Trama ◽  
Antonio Ruffo ◽  
Ester Illiano ◽  
Giuseppe Romeo ◽  
Filippo Riccardo ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Erectile Function ◽  
Tunica Albuginea ◽  
Penile Prosthesis ◽  
Peyronie’S Disease ◽  
Penile Curvature ◽  
Rehabilitation Protocol ◽  
Extracorporeal Shock Wave ◽  
Vacuum Device ◽  
Peyronie's Disease

Background: Peyronie’s disease (PD) is a little-known disease characterized by pain during erections, the presence of penile curvature, and consequent psychological disorders. In addition, concomitant erectile dysfunction may be present. The treatment of PD is adapted to the patient, especially when the penile curvature is >60°; with stabilized pathology, it is preferable to perform penile straightening approaches, such as penile plication and plaque incision, or partial excision and grafting. The most frequent side effect of straightening approaches is the onset of erectile dysfunction due to the formation of venous leakage appearing after the excision of calcific plaque. Materials and methods: All enrolled patients had PD, a curvature >60°, had an IIEF subdomain erectile function score >16, and refused penile prosthesis implantation concurrent with tunica albuginea grafting surgery. Subsequently, 4 weeks after surgery, all patients underwent a rehabilitation protocol that consisted of low-intensity extracorporeal shock wave therapy (Li-ESWT), the administration of 5 mg/daily of tadalafil, and the use of a vacuum device. Results: From January 2014 to March 2016, 15 subjects affected by PD with severe penile curvatures were enrolled in the study. At 6 months after surgery, the IIEF scores for erectile function were not statistically significantly different before and after surgery (p > 0.05); the other items, especially orgasmic function (p = 0.01), sexual desire (p < 0.01), intercourse satisfaction (p = 0.01), and overall satisfaction (p = 0.04), were all statistically significant. The modified EDITS questionnaire reported that 80% of patients were satisfied, that 13.3% were dissatisfied, and that 1 patient (6.6%) was dissatisfied with the surgery. Moreover, there was no statistically significant decrease in the patients’ penile lengths. The aim of this study was to use a rehabilitation protocol consisting of Li-ESWT, the administration of 5 mg/daily, and the use of a vacuum device in order to preserve the erectile function of patients undergoing straightening approaches using surgical grafting. In addition, patient satisfaction following surgery was analyzed.

1072 TUNICA ALBUGINEA CRURAL GRAFT FOR SEVERE PENILE CURVATURE DUE TO PEYRONIE'S DISEASE: 07 YEARS FOLLOW-UP

2010 ◽  
Vol 183 (4S) ◽  
Author(s):  
Claudio Teloken ◽  
Patrick E. Teloken ◽  
Tulio Graziottin ◽  
Caio Schmit ◽  
Rodrigo Blaya
Keyword(s):  
Tunica Albuginea ◽  
Peyronie’S Disease ◽  
Penile Curvature ◽  
Peyronie's Disease

scholarly journals Alei II Technique: Minimally Invasive Technique for the Correction of Penile Curvature without Circumcision

2016 ◽  
Vol 9 (1) ◽  
pp. 70-70
Author(s):  
P. Letizia ◽  
◽  
G. Alei ◽  
A. Rossi ◽  
◽  
...  
Keyword(s):  
Surgical Technique ◽  
Sagittal Plane ◽  
Peyronie’S Disease ◽  
Invasive Technique ◽  
Penile Curvature ◽  
Penile Deviation ◽  
Aesthetic Results ◽  
Peyronie's Disease ◽  
New Surgical Technique

Objective: We describe a new surgical technique for the treatment of penile curvature. In 2012, we developed a new surgical technique for the correction of congenital and acquired penile curvature without circumcision called “track” corporoplasty or Alei II technique Design and Method: For the penile ventral curvature repair an infrapubic transverse dorsal incision is made to correct a ventral curvature or when removing or cutting the plaque in Peyronie’s disease A single 0 non-absorbable synthetic multifilament suture is placed in order to perform a special placation on two parallel lines and therefore called “track”. Laterally to the corporoplasty described, two corporoplasties should be performed along the line that goes from the dorsal neurovascular bundle to the lateral end of the corpus cavernosus at 30° and 60° on the penile sagittal plane. The two corporoplasties should measure 50% at 30° and 25% at 60. Results: Mean age was 43 years for patients with Peyronie’s disease and 31 years for patients with congenital penile deviation. The mean follow-up period was 36 months. No major complications, no circumcision, overall satisfaction 98%. Intraoperative correction of the curvature was achieved in 100%, significant relapse occurred in 2%. Conclusions: This original technique is associated with low morbidity, low recurrence rate and excellent aesthetic results.

scholarly journals Buccal mucosa graft in surgical management of Peyronie’s disease: Ultrasound features and clinical outcomes

2021 ◽  
Vol 93 (1) ◽  
pp. 107-110
Author(s):  
Andrea Fabiani ◽  
Fabrizio Fioretti ◽  
Maria Pia Pavia ◽  
Luca Lepri ◽  
Emanuele Principi ◽  
...  
Keyword(s):  
Surgical Management ◽  
Buccal Mucosa ◽  
De Novo ◽  
Surgical Complication ◽  
Peyronie’S Disease ◽  
Penile Curvature ◽  
Ultrasound Evaluation ◽  
Dynamic Ultrasound ◽  
Peyronie's Disease

Introduction: Plaque incision and grafting represent the best surgical approach to the Peyronie’s Disease (PD). The grafting procedures must be restricted to patients with normal preoperative status, excessive curvature and/or deformities. However, the ideal graft has not been identified yet. Buccal mucosa grafts (BMG) provided excellent short-term results, ensuring the fast return of spontaneous erections and preventing shrinkage, which is the main cause of graft failure. Another fearsome surgical complication is de novo erectile dysfunction (ED). We report our results with BMG focusing on the analysis of ultrasonographic and clinical data demonstrating buccal mucosa as determinant factor that allow to avoid complications. Materials and methods: From 2013 to 2019 we performed at our Urology Unit 27 corporoplasties with BMG to correct complex penile curvature due to PD. Clinical, post-surgical and ultrasound follow up data were evaluated. All patients were no responders to medical treatment or previous surgical procedures. The evaluation period was 72 months. Data regarding pre-operative work-up, including IIEF (IIEF-5) questionnaire administration, detailed clinical history and penile dynamic ultrasound (PGE1-induced erection) were collected. The time of spontaneous erection resumption was recorded for each patient. To improve blood supply to the graft, a low-dose PDE5-i was prescribed for all patients for a period of two months, starting immediately after discharge. Check-ups were scheduled every 3 months, starting from 1 month after surgery. In each visit, patients underwent a penile ultrasound evaluation of graft features. After 6 and 12 months, all patients underwent a penile dynamic ultrasound for Erection Hardness Score determination, then standard ultrasound and clinical evaluation yearly. Our analyses were focused on BMG as a major determinant of the surgical success. Results: Mean age of 27 patients was 57 years (42-71) with a maximum follow up time of 72 months and minimum of 3. Site of penile curvature was dorsal in 18 (67%) patients, ventral in 2 (7%), complex in 7 (26%). The degree of the curvature was < 60° in 11 (41%) patients, > 60° in 16 (59%). Straightening of penis was reached in 100% of cases. Penile shortening resulted in 7.4% (2/27). De novo ED appeared in 2/27 cases with a post-operative rate of PDE5i users increasing from 12 to 14 patients (45% vs 52%). Ultrasound aspects of BMG, recorded at every follow up visit, results in a hypoechoic plaque with an iperechoic rim that become isoechoic over the time in all cases. No case of scars or seroma was registered. Small intra-graft cystic lesions were highlighted in 3 cases (11%).Conclusions: BMG may represent a good choice in grafts procedures for PD surgical management. The functional results obtained by BMG procedures were related to the good anatomical characteristics of the patch and were highlighted in our series by use of penile ultrasound, during the follow up period.

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