Peyronie's disease (CME)

Introduction. The management of Peyronie's disease (PyD) presents several challenges to the clinician. Despite progress in the understanding of PyD on several fronts, it remains a physically and psychologically devastating condition for the affected patient and partner. Aim. The purpose of this Continuing Medical Education article is to review contemporary knowledge of the epidemiology, pathophysiology, evaluation, and management of PyD, thus enabling best-practice management. Methods. An English-language MEDLINE review was performed from 1990 to present-day for PyD. Main Outcome Measure. Current state of, and new developments in, PyD. Results. Recent studies have established a new paradigm for the natural history and epidemiology of PyD. Prevalence approaches 5%, while less than 20% of men report spontaneous resolution of deformity. The psychological sequelae on both patient and partner are underrepresented in literature; data gleaned from select Internet websites have better established Peyronie's effects on psyche and relationships. For the majority of patients, evaluation, information, and reassurance is sufficient. Few medical treatment options are supported by data from well-designed placebo-controlled trials. For men unresponsive to nonoperative therapies, plication, grafting, or implantation of a penile prosthesis are surgical management options. Conclusions. PyD does not invariably progress to a complete loss of the ability for sexual intercourse. Should deformities preclude intercourse, well-established medical or surgical options may be considered; indeed, using one or more of the treatment approaches outlined can, in most cases, result in adequate restoration of sexual function.