Биология ва тиббиёт муаммолари 2024 №6 (157)


Тема статьи

EFFECTIVE MANAGEMENT OF COMPLEX CURVATURE IN PEYRONIE’S DISEASE (28-30)

Авторы

Ateş Kadıoğlu, Abdurakhmonov Farkhod Rakhmonovich

Учреждение

1 - Faculty of Medicine, Department of Urology, Istanbul University, Istanbul, Turkey; 2 - Samarkand State Medical University, Republic of Uzbekistan, Samarkand

Аннотация

About 10% of Peyronie's patients are complex cases with severe curvature (>60 degrees), ventral plaque, multiplanar curvature, hour-glass/hinge deformity, notching deformity, and ossifed plaque. In patients with complex Peyronie’s disease (PD), diferent techniques (shortening procedures, lengthening procedures, and penile prosthesis implantation (IPP)) may be necessary to achieve successful result. This review aims to analyze the various surgical techniques employed in the management of Peyronie's disease, with a specifc focus on patients with complex deformity. Methods Articles focusing on the surgical management of complex curvature in Peyronie’s disease were searched in MEDLINE and PubMed published between 1990 and 2023. Results Shortening procedures are linked to penile shortening and are not recommended for complex cases such as notching, hour-glass deformity, or ossifed plaque. Lengthening procedures are suitable for addressing complex curvatures without erectile dysfunction (ED) and are a more appropriate method for multiplanar curvatures. Penile prosthesis implantation (IPP), with or without additional procedures, is the gold standard for patients with ED and Peyronie's disease. IPP should also be the preferred option for cases of penile instability (hinge deformity) and has shown high satisfaction rates in all complex cases. Conclusion While surgical interventions for complex curvature in Peyronie's disease carry inherent risks, careful patient selection, meticulous surgical techniques, and post-operative care can help minimize complications and maximize positive outcome.

Ключевые слова

Peyronie’s disease, complex curvature, plication, severe curvature, penil prosthesis

Литературы

1. Levine LA (2006) Peyronie’s disease and erectile dys-function: Current understanding and future direction. Indi-an J Urol 22:246–250 2. (2023) EAU Guidelines. Edn. presented at the EAU An-nual Congress Milan (ISBN 978-94-92671-19-6) 3. Osmonov D et al (2022) ESSM position statement on surgical treatment of Peyronie’s disease. Sex Med 10(1):100459 4. Kadioglu A et al (2018) Peyronie’s disease surgery: sur-gical outcomes of 268 cases. Turkish J Urol 44:10–15 5. Choi EJ et al (2021) Intralesional injection therapy and atypical Peyronie’s disease: a systematic review. Sex Med Rev 9(3):434–444 6. Kadioglu A et al (2022) A retrospective review of 307 men with Peyronie’s disease. J Urol 168(3):1075–1079 7. Cakan M et al (2007) The clinical characteristics of Peyronie’s patients with notching deformity. J Sex Med 4(4 Pt 2):1174–1178 8. Abdelsayed GA, Setia SA, Levine LA (2019) The surgi-cal treatment of Peyronie’s disease in the older man: pa-tient characteristics and surgical outcomes in men 65 and older. J Sex Med 16(11):1820–1826 9. Serefoglu E et al (2015) The direction and severity of penile curvature does not have an impact on concomitant vasculogenic erectile dysfunction in patients with Peyronie’s disease. Int J Impot Res 27:6–8 10. Yaf FA et al (2017) Review of management options for patients with atypical Peyronie’s disease. Sex Med Rev 5(2):211–221 11. Kadioglu A et al (2011) Factors afecting the degree of penile deformity in Peyronie disease: an analysis of 1001 patients. J Androl 32(5):502–508 12. Hatzichristodoulou G (2018) Introducing the ventral sealing technique using collagen feece for surgical therapy of patients with ventral Peyronie’s curvature: initial expe-rience. Int J Impot Res 30(6):306–311 13. Krishnappa P et al (2019) Surgical management of Peyronie’s disease with co-existent erectile dysfunction. Sex Med 7(4):361–370 14. Falcone M et al (2020) Strategies and current practices for penile lengthening in severe Peyronie’s disease cases: a systematic review. Int J Impot Res 32(1):52–63 15. Reddy RS et al (2018) Plication for severe Peyronie’s deformities has similar long-term outcomes to milder cases. J Sex Med 15(10):1498–1505 16. Belshof A et al (2021) Human penile ossifcation: a rare cause of sexual dysfunction—a case report and review of the literature. Cureus 13(1):e12675 17. Vernet D et al (2005) Evidence that osteogenic progen-itor cells in the human tunica albuginea may originate from stem cells: implications for Peyronie disease. Biol Reprod 3(6):1199–1210 18. Levine LA, Lenting EL (1997) A surgical algorithm for the treatment of Peyronie’s disease. J Urol 158:2149–2152 19. Eisenberg ML et al (2011) Tunica-sparing ossifed Peyronie’s plaque excision. BJU Int 107(4):622–625