Assesment of the efficiency of conservative treatment of Peyronie’s disease

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Abstract

There were 27 men under observation who got conservative treatment for Peyronie's disease. The criteria for inclusion in the study were the maximum size of the plaque of the penis up to 1.5 cm and the angle of curvature of the penis is less than 45 degrees. Before treatment, after 6 and 12 months, patients underwent ultrasonic dopplerography of the penis, the velocity of blood flow in the cavernous and dorsal arteries and the size of the plaque were determined. All observed patients were prescribed combined therapy, such as symptomatic, immunological and physiotherapeutic treatment. In this case, the patients of the 1st group (n = 15) additionally got longidase treatment (intramuscularly for 3000 IU every 3 days, for a course of 10 injections with concurrent administration of rectal suppositories with longidase at the same dose for a course of 10 suppositories). Locally, these patients were assigned phonophoresis with lengidase on the plaque area (10 sessions). The remaining 12 patients (2nd group) didn’t got longidase treament. Six months after the start of treatment the absence of plaques was recorded in 8 (53.3%) patients in the 1st group and 4 (33.3%) in the 2nd group of patients and in 12 months in 11 (73.3%) and 6 (41.6%) patients. Thus, conservative therapy in Peyronie's disease is effective in patients in the early stages of the disease with moderate deviation of the penis and plaques up to 1.5 cm. The inclusion of longidase in the complex therapy increases the effectiveness of the treatment.

About the authors

Svetlana N. Kalinina

North-Western State Medical university named after I.I. Mechnikov

Author for correspondence.
Email: kalinina_sn@mail.ru

Doctor of Medical Science, Professor, Urology Department

Russian Federation, Saint Petersburg

Vladimir N. Fesenko

North-Western State Medical university named after I.I. Mechnikov

Email: fesvn_spb@mail.ru

Candidate of Medical Science, Associate Professor, Urology Department

Russian Federation, Saint Petersburg

Anton V. Nikolskii

Aleksandrovskaya Hospital

Email: fesvn_spb@mail.ru

Candidate of Medical Science, Urologist, Department of Urology

Russian Federation, Saint Petersburg

Oleg O. Burlaka

Aleksandrovskaya Hospital

Email: burlaka@list.ru

Candidate of Medical Science, Head of Department of Urology

Russian Federation, Saint Petersburg

Natalia V. Marchenko

Aleksandrovskaya Hospital

Email: burlaka@list.ru

Head of Department of Physiotherapy

Russian Federation, Saint Petersburg

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2. Fig. 1. Diagnosis of curvature of the penis on the apparatus AMVL-01 (apparatus vacuum-laser therapeutic urological) in patient A., 54 years old, with Peyronie's disease. Local negative pressure with maximum discharge in the flask affects the baro-and thermoreceptors of the skin of the penis, enhances microcirculation in its vessels. An insignificant curvature (angle of curvature - 30 degrees) of the penis

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3. Fig. 2. Ultrasound dopplerography of the penis of Patient D (36 years old with Peyronie’s disease and venogenic erectile dysfunction): a) in the distal part of the penis, the plaques are from 1–2 to 8.5 mm; b) the dorsal vein did not collapse, and blood flow along it was 30 ml/min. Valsalva test was positive

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4. Fig. 3. Ultrasound dopplerography of the penis of Patient T (55 years old with Peyronie’s disease and venogenic erectile dysfunction). The patient has Dupuytren’s contracture: a) abnormality of the structure of the cavernous arteries, i.e., anastomosis of the cavernous arteries in the crus of the penis; b) plaques in the cavernous bodies (plaque of 11.4 mm × 4.6 mm × 9.2 mm is marked), which deformed the penis; c) and d) noncollapse concurrence of the dorsal vein as a sign of venous erectile dysfunction

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Copyright (c) 2018 Kalinina S.N., Fesenko V.N., Nikolskii A.V., Burlaka O.O., Marchenko N.V.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
 


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