Recent advances in Penile Curvatures
Mustafa Farid Ragab;
Abstract
Penile curvatures can be congenital or acquired. The congenital penile curvatures are usually associated with urethral disease namely; hypospadius and epispadius, and it can be with normal opening of the urethra.
Acquired penile curvatures are due to either Peyronie's disease, or, they may have other causes, such as trauma including; burn, self inflected trauma, external injury, injection therapy, or iatrogenic trauma, also long penile urethral stricture and chronic inflammation or infection to the urethra cause spongiofibrosis and curvature.
Peyronie's disease (PD) is well known and least understood disease. It is an inflammatory condition which is characterized by the formation of fibrous, noncompliant nodules within the tunica albuginea.
The most popular theory for the cause of Peyronie's disease is, repeated penile trauma during intercourse causing succession of inflammatory responses which heals by fibrosis and ends with the plaque formation.
Comorbidities of Pyeronie's disease were found to be; Dupuytren’s contracture, Diabetes mellitus, hypertension, hyperlipidemia, ischemic heart diseases, smoking, hyperuricemia, perineal or genital trauma, and lipoma. Researches failed to name risk factor for Peyronie's disease but found that risk factors of systemic vascular disease associate with more severe curvatures.
Pyeronie's disease can affect young adult males with the youngest reported case was 19 years old. Patients ≤ 40 years suffering from PD has only significant risk factor which is hypercholesterolemia. They tend to have severe pain and less curvature and much less ED than older patients.
Penile curvatures have major effect on patients' sexual lives. Congenital curvatures collectively cause much less effect than acquired curvatures. Almost 80 % of patients of Peyronie's disease have concurrent erectile dysfunction (ED) mostly due to venous leakage. PD also causes major psychic impact on the patient.
Diagnosis of penile curvatures is usually achieved by history and physical examination, yet, laboratory investigations and imaging are important for good evaluation. The best diagnostic tool is high resolution ultrasound and color doppler ultrasound on the penis and penile vessels.
Treatment of penile curvatures depends on cause, severity, and presence of ED.
Congenital penile curvatures are only treated surgically by either shortening techniques that shorten the convex side of the penis such as; (Nesbit's operation with its modifications, incisional corpoplasty, plication corpoplasty, and 16-dot plication). Or, lengthening techniques such as incision and grafting, or excision of grafting of the concave side.
Acquired penile curvatures are due to either Peyronie's disease, or, they may have other causes, such as trauma including; burn, self inflected trauma, external injury, injection therapy, or iatrogenic trauma, also long penile urethral stricture and chronic inflammation or infection to the urethra cause spongiofibrosis and curvature.
Peyronie's disease (PD) is well known and least understood disease. It is an inflammatory condition which is characterized by the formation of fibrous, noncompliant nodules within the tunica albuginea.
The most popular theory for the cause of Peyronie's disease is, repeated penile trauma during intercourse causing succession of inflammatory responses which heals by fibrosis and ends with the plaque formation.
Comorbidities of Pyeronie's disease were found to be; Dupuytren’s contracture, Diabetes mellitus, hypertension, hyperlipidemia, ischemic heart diseases, smoking, hyperuricemia, perineal or genital trauma, and lipoma. Researches failed to name risk factor for Peyronie's disease but found that risk factors of systemic vascular disease associate with more severe curvatures.
Pyeronie's disease can affect young adult males with the youngest reported case was 19 years old. Patients ≤ 40 years suffering from PD has only significant risk factor which is hypercholesterolemia. They tend to have severe pain and less curvature and much less ED than older patients.
Penile curvatures have major effect on patients' sexual lives. Congenital curvatures collectively cause much less effect than acquired curvatures. Almost 80 % of patients of Peyronie's disease have concurrent erectile dysfunction (ED) mostly due to venous leakage. PD also causes major psychic impact on the patient.
Diagnosis of penile curvatures is usually achieved by history and physical examination, yet, laboratory investigations and imaging are important for good evaluation. The best diagnostic tool is high resolution ultrasound and color doppler ultrasound on the penis and penile vessels.
Treatment of penile curvatures depends on cause, severity, and presence of ED.
Congenital penile curvatures are only treated surgically by either shortening techniques that shorten the convex side of the penis such as; (Nesbit's operation with its modifications, incisional corpoplasty, plication corpoplasty, and 16-dot plication). Or, lengthening techniques such as incision and grafting, or excision of grafting of the concave side.
Other data
| Title | Recent advances in Penile Curvatures | Other Titles | الجديد حول انحناءات القضيب | Authors | Mustafa Farid Ragab | Issue Date | 2014 |
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