1. Dr MJ Engelbrecht Dept. Urology University of Pretoria
Peyronies Disease
Dr MJ Engelbrecht
Dept. Urology
University of Pretoria

2. Definition Described by Francois Gigot de la Peyronie in 1743
Also known as induratio penis plastica
Fibrotic induration of the penis with concurrent curvature

3. Clinical presentation
Peak incidence
4th to 6th decades
Pain and penile curvature during erection
Difficult intercourse
Impotence in some cases
A hard fibrotic mass is felt on palpation

4. Clinical presentation

5. Clinical presentation

6. Etiology Fibrosing condition of the tunica albuginea
Repetative microtrauma is most probably the inciting event
Dupuytrans contracture has been associated with PD
Always examine the hands
Possible genetic aetiology

7. Etiology

8. Clinical course Most cases is self limiting
Devided into acute and chronic phase
In the acute phase
Pain
Worsening of the deformity
Enlargement of the plaque
12 to 18 months duration
Chronic phase
No pain
Stable deformity

9. Treatment Medical Usually during the acute phase Oral therapy
Vitamin E
Potassium para-amino benzoate
Colchicine
Tamoxifen
Pentoxifylline

10. Treatment Transdermal therapies Intralesional Other therapies
Verapamil
Intralesional
INF alpha 2 beta
Saline
Intralesional therapies not for cure, but more for prevention of progression
Other therapies
ESWL

11. Surgical treatment
Reserved for patients with PD for at least 12 months (chronic phase) and a stable deformity for at least 3 months
3 groups of surgery
Penile shortening
Penile lengthening
Penile prostesis

12. Surgical Treatment ED + - Short penis Penile Prostesis Normal length
> 45 degrees
Normal length
< 30 degrees
Penile lengthening
procedure
Penile shortening
procedure
Nesbit
Graft

13. Penile Shortening (Nesbit Plication)
Surgical treatment
Penile Shortening (Nesbit Plication)

14. Surgical treatment
Penile prostesis