Diagnostics

Peyronie’s disease

What is Peyronie’s disease?

The penis consists of 2 cavernous bodies and a spongy body surrounding the urethra (channel in which the urine flows) and it ends with the glans. The cavernous bodies are covered with a thick and elastic membrane that is called albuginea. During erection, it allows an elongation and an increase in volume to create an erection. Peyronie’s disease is a localized and segmental fibrosis of the corpus cavernosum that causes penile curvature during erection.

What is the cause of Peyronie's disease?
No cause has been identified. The hypotheses are numerous; of these, 37% are cases of trauma.
What are the medical predispositions?
About 10% of Peyronie’s disease patients have also Dupuytren's disease. Otherwise, diabetes, smoking, betablocking, Paget's disease or rheumatoid arthritis are diseases that can contribute to the development of La Peyronie's disease.
What is the incidence of Peyronie’s disease?
The incidence of Peyronie's disease is 7%. The average age of onset of the disease is 53 years and it is exceptional before 40 years.
What is the evolution of Peyronie’s disease?
The evolution of the curvature of the penis is variable. The curvature may as well disappear spontaneously as evolve into a severe deformation. It is therefore difficult to determine what will be the evolution of the curvature at the beginning of the disease.

Generally, Lapeyronie's disease evolves in 2 phases:

Initial phase The initial inflammatory phase is marked by pain and / or nodule and deformity of the erect penis. The pain can be felt spontaneously or only during an erection. In the majority of cases, the pain seems to disappear within 12 to 18 months.

Secondary phase The secondary phase is characterized by a stable curvature. Often, the patient feels no pain at this stage
How is made the diagnosis of Peyronie’s disease?
A physical examination and a medical history of the patient make it possible to establish a diagnosis. There is no need for diagnostic tests.
What are the medical treatments?
In the initial phase: the nonsurgical service of shock waves helps the resorption of the pain.

In late phase: the surgical correction of plication is intended to correct the curvature of the penis.
Is there infiltration treatment of the plaque?
Collagenase is not yet available in Canada (XIAFLEX). It is expected to be accepted by Health Canada in February 2018. In studies, she is credited with improving curvature, plaque size and erectile dysfunction. This treatment is rather expensive. It will require several treatments or about 4 sessions.

Infiltration of platelet-rich plasma (PRP) with hyaluronic acid is a new treatment now accepted by Health Canada. It's about taking a blood sample. This is centrifuged to obtain the plasma surface. The patient's plasma is harvested and reinjected at the plaque site. This treatment is offered in private practice at Dr. Carlos Marois Urologist Private clinics. It is performed under local anaesthesia with a penile block. It is performed under ultrasound guidance to identify the plate. It requires several sessions every 2 weeks, approximately 4 sessions. A penis extender can be used in combination to improve results. It is sometimes necessary to carry out maintenance treatment to the months until the stability of the disease. The satisfaction rate is high with a correction of approximately 15% of the curvature in 75% of the treated patients.
Is there a physical treatment?
Extracorporeal shock wave lithotripsy seems to demonstrate a faster resolution of pain in the initial phase. This treatment is offered in private practice at Dr. Carlos Marois Urologist Private clinics. The treatment of the plate consists of a meeting of 30 minutes per week, during 4 weeks.
What are the treatments for penile Peyronie’s curvature?
Medical treatments Penile rich plasma (PRP) penile injection Extracorporeal Lithotripsy Surgical treatment by correction plication

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