Penile plastic induration (Peyronie Disease) pathogenetic treatment

Introduction. Peyronie disease is a focal fibrosis of penile fibrous tunic. Peyronie disease in last decade becomes very important social problem in urological patients. Peyronie disease morbidity rates are 388 per 10000, increase for 25.7 per 10000 per year. Etiology and pathogenesis of Peyronie disease is still not totally investigated. Mean patients' age 50 - 60 years, 25% of them have erectile dysfunction. Peyronie disease morbidity correlates with age. Conservative treatment is indicated in a first period of disease before plaque's calcification is formed and deformation angle is less than 30 - 45°. Surgery is indicated when deformation is more than 45° leading to sexual intercourse difficulties. Plication surgeries with plaque excision, plastic surgeries and penile prosthesis implantation are used. Conservative treatment is very numerous. Materials and methods. 33 patients age ranged 25 - 66(mean 45.5) years surveyed. All with complaints of penile deformation, erectile dysfunctions of various degree, penile focal indurations. Diagnostic investigation included physical examination, deformation degree measurements, ultrasound and Doppler methods with circulation assessment, questionaries, PSA, laboratory analysis. All patients were divided into 2 groups. Both group had a complex treatment course, first one with longidasa included. Control group was 20 patients with erectile dysfunction without Peyronie disease. Longidasa was injected intramuscularly with suppositories insertion. In some cases longidasa was injected directly into plaque. Results and discussion. Initially 72% of patients in group 1 had plaques sized more than 0.5 cm. Six month and one year later after the treatment only 33% and 22% respectively of patients had plaques sized more than 0.5 cm. Conclusion. Longidasa is indicated for patients with Peyronie disease, especially in patients not suitable for surgery because of high anaesthetic risk.