scholarly journals Pathological Significance of Macrophages in Erectile Dysfunction Including Peyronie’s Disease

Biomedicines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1658
Author(s):  
Yasuyoshi Miyata ◽  
Tomohiro Matsuo ◽  
Yuichiro Nakamura ◽  
Kensuke Mitsunari ◽  
Kojiro Ohba ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Tunica Albuginea ◽  
Healing Process ◽  
Treatment Strategies ◽  
Peyronie’S Disease ◽  
Pathological Mechanism ◽  
Peyronie's Disease ◽  
Phosphodiesterase Type

Erectile function is regulated by complex mechanisms centered on vascular- and nerve-related systems. Hence, dysregulation of these systems leads to erectile dysfunction (ED), which causes mental distress and decreases the quality of life of patients and their partners. At the molecular level, many factors, such as fibrosis, lipid metabolism abnormalities, the immune system, and stem cells, play crucial roles in the etiology and development of ED. Although phosphodiesterase type 5 (PDE5) inhibitors are currently the standard treatment agents for patients with ED, they are effective only in a subgroup of patients. Therefore, further insight into the pathological mechanism underlying ED is needed to discuss ED treatment strategies. In this review, we focused on the biological and pathological significance of macrophages in ED because the interaction of macrophages with ED-related mechanisms have not been well explored, despite their important roles in vasculogenic and neurogenic diseases. Furthermore, we examined the pathological significance of macrophages in Peyronie’s disease (PD), a cause of ED characterized by penile deformation (visible curvature) during erection and pain. Although microinjury and the subsequent abnormal healing process of the tunica albuginea are known to be important processes in this disease, the detailed etiology and pathophysiology of PD are not fully understood. This is the first review on the pathological role of macrophages in PD.

scholarly journals US Imaging in Peyronie's Disease

2012 ◽  
Vol 2 ◽  
pp. 63 ◽  
Author(s):  
Kiriaki Kalokairinou ◽  
Charalampos Konstantinidis ◽  
Marilena Domazou ◽  
Theodoros Kalogeropoulos ◽  
Prodromos Kosmidis ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Imaging Modality ◽  
Tunica Albuginea ◽  
Peyronie’S Disease ◽  
Low Risk ◽  
Penile Curvature ◽  
Appropriate Treatment ◽  
Peyronie's Disease ◽  
Non Palpable Lesions

The aim of this study is to assess the role of ultrasound (US) in Peyronie's Disease (PD). PD is a psychologically and physically devastating disorder that manifests in middle-aged men. Fibrous inelastic plaques in the tunica albuginea, result in palpable penile scar in the flaccid condition and cause painful erections and penile deformity, including penile curvature, hinging, narrowing, and shortening of penis. Penile deformity is the most common (52%) first symptom of PD and is present in 94% of affected men. US is the primary imaging modality of choice due to its easy availability, low risk, and ability to image and quantify both calcified and soft tissue elements of PD. US provides identification of smaller and non-palpable lesions and shows the extent of fibrosis. Detection of calcifications within the plaque suggests stabilization of the disease and provides information useful to select patients for appropriate treatment.

scholarly journals Use of inflatable penile prostheses AMS CX with momentary squeeze in a patient with Peyronie’s disease after removal of two previously implanted penile prostheses

2014 ◽  
Vol 86 (1) ◽  
pp. 46
Author(s):  
Patrizio Vicini ◽  
Ferdinando De Marco ◽  
Gabriele Antonini ◽  
Ettore De Berardinis ◽  
Riccardo Giovannone ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Tunica Albuginea ◽  
Penile Prosthesis ◽  
Longitudinal Axis ◽  
Peyronie’S Disease ◽  
Neurovascular Bundle ◽  
Complex Case ◽  
Sexual Life ◽  
Penile Prostheses ◽  
Peyronie's Disease

Objective: Peyronie's disease (PD) is a fibrotic wound-healing condition of the tunica albuginea that results in penile deformity, curvature, hinging, narrowing and shortening, penile pain, and in some cases, erectile dysfunction (ED). Surgery remains the gold standard treatment option, ensuring the faster and trustworthy treatment. For those patients who have erectile dysfunction and PD, penile prosthesis placement with straightening procedure is the best method to solve both diseases. The aim of this article is to present the use of hydraulic penile prostheses AMS CX with Momentary Squeeze associated with a complete isolation of the neurovascular bundle in a complex case after removal of two previously implanted prostheses in a man suffering from Peyronie’s disease and erectile dysfunction. Material and method: A 50 year-old patient underwent two previous prosthetic implants in another hospital. The first implantation was performed using an infrapubic approach followed by placement of a three-component hydraulic penile prosthesis. After six months the prosthesis was removed using an infra-pubic approach and two soft prosthesis Virilis II were implanted during the same surgery. One year after the second operation we implanted a hydraulic penile prosthesis AMS CX with Mo - mentary Squeeze after complete isolation of the neurovascular bundle, fixing the two crural tips at the same level of albuginea of the two corpora cavernosa. Result: Twelve months after surgery the penis was completely straight without penile shortening and the patient was fully satisfied with his sexual life. Conclusion: The procedure enabled a perfect alignment of the cylinders along the longitudinal axis and penile prosthetic symmetry to obtain a good penile rigidity and a perfect penile straightening.

scholarly journals Peyronie's Disease: Evolving Surgical Management and the Role of Phosphodiesterase 5 Inhibitors

2009 ◽  
Vol 9 ◽  
pp. 822-845 ◽  
Author(s):  
Tariq F. Al-Shaiji ◽  
Gerald B. Brock
Keyword(s):  
Tunica Albuginea ◽  
Surgical Techniques ◽  
Peyronie’S Disease ◽  
Surgical Approaches ◽  
Penile Curvature ◽  
Advantages And Disadvantages ◽  
Phosphodiesterase 5 Inhibitors ◽  
Peyronie's Disease ◽  
Phosphodiesterase 5

Peyronie's disease (PD) is a fibrotic disorder of the tunica albuginea of the penis. It is characterized by different degrees of penile curvature and sexual dysfunction. Several medical treatments have been employed to manage the disorder, with variable success rates. Surgical therapy is reserved for patients with severe penile deformity that fails to improve with medical treatment and impedes coital function. The advantages and disadvantages of various surgical approaches have long been debated. Herein, we describe the evolving surgical techniques for PD using knowledge obtained from the contemporary literature. In addition, we discuss the emerging data regarding the role of phosphodiesterase 5 inhibitors in the management of PD.

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.

scholarly journals Biomechanical Simulation of Peyronie’s Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Pavel Drlík ◽  
Vladimír Červenka ◽  
Jan Červenka
Keyword(s):  
Tunica Albuginea ◽  
Healing Process ◽  
Element Model ◽  
Peyronie’S Disease ◽  
Corpus Cavernosa ◽  
Geometrical Shape ◽  
Angular Deviation ◽  
Biomechanical Behavior ◽  
Peyronie's Disease ◽  
Initial Strains

A pathological disorder of human penile function, known as Peyronie’s disease, is characterized by the formation of plaque particles within the tunica albuginea. The plagues in the shape of rigid plate form in the scars as a result of the imperfect healing process. Due to high stiffness, plagues are the source of pain and anomalous deformations during erectile penis function. The authors simulate the biomechanical behavior of the penile structure by a 3D finite element model. The numerical model is based on the real geometrical shape and the tissue structure with consideration of large nonlinear deformations. The penile erection is modeled by the initial strains imposed on the corpus cavernosa. The stress analysis is performed in a case study of various plague locations. The Peyronie’s syndrome manifested by the penis angular deviation simulated by the analysis is compared with the clinical data. The computational simulations provide a rational explanation for the clinical observations on patients. The objective is to apply the proposed modeling approach for the development and validation of treatment methods based on the application of shock waves.

scholarly journals Androtherm Application for the Peyronie's Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
M. Ballerini ◽  
G. F. Baronzio ◽  
G. Capitò ◽  
O. Szasz ◽  
V. Cassutti
Keyword(s):  
Erectile Dysfunction ◽  
Tunica Albuginea ◽  
Peyronie’S Disease ◽  
Penile Length ◽  
Appropriate Treatment ◽  
Peyronie's Disease

Peyronie's disease is characterized by a scarring fibrosis within the tunica albuginea of the penis that could lead to penile length loss, narrowing, curvature, erectile dysfunction, or pain with erection. This problem has recently no appropriate treatment. Our objective is to treat this kind of disease by a new kind of hyperthermia method.

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