Peyronie’s disease

Abstract

Peyronie's disease, also known as penile fibromatosis, is an acquired connective tissue disorder associated with the appearance of fibrotic nodules in the tunica albuginea of the penis, reducing its local elasticity and curving the penis during erection. Peyronie's disease increases in frequency with age, with its highest incidence during the fifth decade of life. Pathophysiologically, the exact cause of the formation of fibrotic plaques in the tunica albuginea is unknown, mainly associated with micro traumas during penetration. Additionally different hypotheses have been formulated as, for example, the dysfunction of matrix metalloproteinases, by which there would be a persistence of fibrotic tissue. Clinically there are two spectra of the disease, the acute phase and the stable phase, a patient with an acute picture will present with penile pain, changes in the penis during erection as curvatures or malformations, in a stable picture, the patient has no penile pain during erection and presents a penile curvature without further progression of the malformation. Both presentations are associated with psycho-social affectation of the patients, which is of extreme relevance and must be approached in an integral way with the treatment of the symptoms of the disease. During the clinical evaluation, therapeutic decisions will be made in relation to the extent of penile curvature and oral medical treatment with pentoxifylline or intralesional injections could be given. Additionally, there is the option of surgical treatment for certain cases of the disease.