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Can O, Özbir S, Atalay HA, Çakır SS, Culha MG, Canat HL. The relationship between testosterone levels and Peyronie's disease. Andrologia 2020; 52:e13727. [PMID: 32589321 DOI: 10.1111/and.13727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/06/2020] [Accepted: 05/31/2020] [Indexed: 12/23/2022] Open
Abstract
Aetiologic and predisposing factors are still controversial about Peyronie's disease (PD). However, it is thought to be the result of connective tissue disorder or healing defect. Androgens are known to affect collagen metabolism and wound healing in the body. The aim of this study was to investigate the relationship between PD and low testosterone levels. One hundred and forty-seven Peyronie patients and 137 healthy volunteers were included in the study. In both groups, demographic data, medical history, physical examination and erectile capacity were recorded. Blood samples were collected from all subjects in the early morning hours after an overnight fast. The mean level of serum total testosterone was lower in men with PD compared with the controls (3.9 ± 1.1 vs. 4.2 ± 1.7 ng/ml respectively) (p = .062). However, statistically significant relationship was not found between PD and low serum testosterone levels. There was no significant correlation between penile plaque dimension or penile curvature degree and testosterone levels. Large randomised-controlled prospective studies are needed to reveal this possible association.
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Affiliation(s)
- Osman Can
- Department of Urology, Basaksehir City Hospital, Istanbul, Turkey
| | - Sait Özbir
- Department of Urology, Cemil Taşcıoglu City Hospital, Istanbul, Turkey
| | | | - Süleyman Sami Çakır
- Department of Urology, Atlas University, Medicine Hospital, Istanbul, Turkey
| | | | - Halil Lütfi Canat
- Department of Urology, Cemil Taşcıoglu City Hospital, Istanbul, Turkey
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Canat HL, Can O, Ozbir S, Cakir SS, Culha MG, Bayraktarli RY, Atalay HA. Is high levels of vitamin D a new risk factor for Peyronie's disease? Andrologia 2019; 51:e13368. [DOI: 10.1111/and.13368] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/31/2019] [Accepted: 06/07/2019] [Indexed: 12/15/2022] Open
Affiliation(s)
- Halil Lutfi Canat
- Department of Urology, Okmeydani Training and Research Hospital University of Health Sciences Istanbul Turkey
| | - Osman Can
- Department of Urology, Okmeydani Training and Research Hospital University of Health Sciences Istanbul Turkey
| | - Sait Ozbir
- Department of Urology, Okmeydani Training and Research Hospital University of Health Sciences Istanbul Turkey
| | - Suleyman Sami Cakir
- Department of Urology, Okmeydani Training and Research Hospital University of Health Sciences Istanbul Turkey
| | - Mehmet Gokhan Culha
- Department of Urology, Okmeydani Training and Research Hospital University of Health Sciences Istanbul Turkey
| | - Recep Yilmaz Bayraktarli
- Department of Radiology, Okmeydani Training and Research Hospital University of Health Sciences Istanbul Turkey
| | - Hasan Anıl Atalay
- Department of Urology, Okmeydani Training and Research Hospital University of Health Sciences Istanbul Turkey
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Liu Y, Zheng D, Liu X, Shi X, Shu S, Li J. Ultrasound on Erect Penis Improves Plaque Identification in Patients With Peyronie's Disease. Front Pharmacol 2019; 10:312. [PMID: 31019463 PMCID: PMC6458259 DOI: 10.3389/fphar.2019.00312] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 03/14/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To compare the sensitivity of identification of penile plaques in the erect and flaccid penises by ultrasound in patients with Peyronie's disease (PD). MATERIALS AND METHODS A total of 75 PD patients were screened by palpation and ultrasonography for penile lesions in both flaccid and erect penises induced by prostaglandin E1 (PG-1) injection. RESULTS A total of 138 lesions were identified by ultrasound in the erect penises induced by injection of PG-1. However, only 74.6% of the lesions (103) were detectable by the palpation of the flaccid penises, and 84.1% (116) by ultrasound of the flaccid penises. The ultrasound confirmed 99 of the palpated lesions in the flaccid penises. The detection rate of lesions in drug-induced erect penises by ultrasound was significantly higher than those in the flaccid penises by the ultrasound (P < 0.01) or palpation (P < 0.0005) The type of penile lesions identified by ultrasonography included tunical thickening, calcifications, septal fibrosis, and intracavernosal fibrosis. The ratios of these lesions confirmed by ultrasound were 52.6, 33.6, 6.0, and 7.8%, respectively, in the flaccid penises, and 55.8, 28.3, 8.7, and 7.2%, respectively, in the erect penises. CONCLUSION Drug-induced erection can be used in suspicious PD patients when penile lesion is not identified by palpation or ultrasound in the flaccid penis.
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Affiliation(s)
- Yu Liu
- Department of Ultrasonography, Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Dequan Zheng
- Andrology Center, Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Xiaolin Liu
- Department of Ultrasonography, Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Xiaohong Shi
- Department of Ultrasonography, Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Shengchun Shu
- Department of Ultrasonography, Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
| | - Jinbing Li
- Department of Ultrasonography, Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
- *Correspondence: Jinbing Li,
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Abstract
INTRODUCTION Peyronie disease (PD) is a progressive fibrotic disorder of the penile tunica albuginea that results in fibrotic penile plaques and can lead to penile deformity. Characterized by aberrant fibrosis resulting in part from the persistence of myofibroblasts and altered gene expression, the molecular factors underpinning PD and other related fibrotic diatheses are just being elucidated. A genetic link to PD was first identified three decades ago using pedigree analyses. However, the specific genetic factors that predispose patients to aberrant fibrosis remain unknown, and the relations between these fibrotic conditions and other heritable diseases, including malignancy, are uncharacterized. AIM To review the current landscape linking molecular and genetic factors to aberrant fibrosis in PD and related fibrotic diatheses, including Dupuytren disease. METHODS Review and evaluation of the literature from 1970 to the present for genetic factors associated with PD were performed. MAIN OUTCOME MEASURES Data describing the genetic factors associated with PD were obtained. RESULTS We describe the known structural chromosomal abnormalities and single-nucleotide polymorphisms associated with fibrotic diatheses and discuss the spectrum of differential gene expression data comparing normal tissues with those derived from men with PD or Dupuytren disease. We discuss epigenetic mechanisms that might regulate gene expression and alter predisposition to fibrosis. CONCLUSION Although the current understanding of the genetic factors associated with PD is limited, significant advances have been made during the past three decades. Further research is necessary to provide a more comprehensive understanding of the landscape of genetic factors responsible for the development of PD.
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Yafi FA, Pinsky MR, Sangkum P, Hellstrom WJG. Therapeutic advances in the treatment of Peyronie's disease. Andrology 2015; 3:650-60. [PMID: 26097120 DOI: 10.1111/andr.12058] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 04/30/2015] [Accepted: 05/05/2015] [Indexed: 12/17/2022]
Abstract
Peyronie's disease (PD) is an under-diagnosed condition with prevalence in the male population as high as 9%. It is a localized connective tissue disorder of the penis characterized by scarring of the tunica albuginea. Its pathophysiology, however, remains incompletely elucidated. For the management of the acute phase of PD, there are currently numerous available oral drugs, but the scientific evidence for their use is weak. In terms of intralesional injections, collagenase clostridium histolyticum is currently the only Food and Drug Administration-approved drug for the management of patients with PD and a palpable plaque with dorsal or dorsolateral curvature >30°. Other available intralesional injectable drugs include verapamil and interferon-alpha-2B, however, their use is considered off-label. Iontophoresis, shockwave therapy, and radiation therapy have also been described with unconvincing results, and as such, their use is currently not recommended. Traction therapy, as part of a multimodal approach, is an underused additional tool for the prevention of PD-associated loss of penile length, but its efficacy is dependent on patient compliance. Surgical therapy remains the gold standard for patients in the chronic phase of the disease. In patients with adequate erectile function, tunical plication and/or incision/partial excision and grafting can be offered, depending on degree of curvature and/or presence of destabilizing deformity. In patients with erectile dysfunction non-responsive to oral therapy, insertion of an inflatable penile prosthesis with or without straightening procedures should be offered.
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Affiliation(s)
- F A Yafi
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - M R Pinsky
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - P Sangkum
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - W J G Hellstrom
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
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Jung KH, Ryu YL, Lee HS, Lee H, Son MK, Yan HH, Hong SW, Ryu JK, Hong S, Suh JK, Hong SS. A novel PI3K inhibitor alleviates fibrotic responses in fibroblasts derived from Peyronie's plaques. Int J Oncol 2013; 42:2001-8. [PMID: 23588860 DOI: 10.3892/ijo.2013.1905] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 03/22/2013] [Indexed: 01/18/2023] Open
Abstract
Peyronie's disease (PD) is fibrosis localized in the tunica albuginea that is characterized by penile deformity and curvature. The pathogenesis of this disease remains unclear even though transforming growth factor-β (TGF-β)/smad signalling has been reported to be associated with PD. Recent studies have shown that phosphoinositide 3-kinase (PI3K)/Akt signalling regulates fibrotic responses including collagen synthesis and cell proliferation. Thus, we synthesized HS-173, a novel PI3K inhibitor, and determined whether this compound has anti-fibrotic effects on PD-derived primary fibroblasts. In this study, we found that HS-173 inhibited the growth of fibroblasts in a dose-dependent manner and induced apoptosis. In addition, HS-173 reduced the expression of α-smooth muscle actin (α-SMA), vimentin, PAI-1, fibronectin, collagen type I, collagen IV and TGF-β-activated smad2/3 in PD-derived primary fibroblasts. HS-173 blocked the PI3K/Akt signalling pathway by decreasing the activation of Akt, mTOR and P70S6K. Our results showed that HS-173 suppressed fibrotic responses such as cell proliferation and collagen synthesis by blocking PI3K/Akt signalling in PD-derived primary fibroblasts. Our findings provide molecular insights into the potential therapeutic action of HS-173 through targeting the PI3K/Akt pathway in PD-derived fibroblasts and demonstrated that HS-173 could be used as a pharmacological agent for treating other fibrotic diseases.
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Affiliation(s)
- Kyung Hee Jung
- Department of Biomedical Sciences, College of Medicine, Inha University, Incheon 400-712, Republic of Korea
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Ralph D, Gonzalez-Cadavid N, Mirone V, Perovic S, Sohn M, Usta M, Levine L. The management of Peyronie's disease: evidence-based 2010 guidelines. J Sex Med 2010; 7:2359-74. [PMID: 20497306 DOI: 10.1111/j.1743-6109.2010.01850.x] [Citation(s) in RCA: 220] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The field of Peyronie's disease is evolving and there is need for a state-of-the-art information in this area. AIM To develop an evidence-based state-of-the-art consensus report on the management of Peyronie's disease. METHODS To provide state-of-the-art knowledge regarding the prevalence, etiology, medical and surgical management of Peyronie's Disease, representing the opinion of leading experts developed in a consensus process over a 2-year period. MAIN OUTCOME MEASURES Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation, and debate. CONCLUSIONS The real etiology of Peyronie's disease and the mechanisms of formation of the plaque still remain obscure. Although conservative management is obtaining a progressively larger consensus among the experts, surgical correction still remains the mainstay treatment for this condition.
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Ryu JK, Piao S, Shin HY, Choi MJ, Zhang LW, Jin HR, Kim WJ, Han JY, Hong SS, Park SH, Lee SJ, Kim IH, Lee CR, Kim DK, Mamura M, Kim SJ, Suh JK. IN-1130, a Novel Transforming Growth Factor-β Type I Receptor Kinase (Activin Receptor-like Kinase 5) Inhibitor, Promotes Regression of Fibrotic Plaque and Corrects Penile Curvature in a Rat Model of Peyronie's Disease. J Sex Med 2009; 6:1284-96. [DOI: 10.1111/j.1743-6109.2009.01216.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chung H, Lee CK, Kim B, Kim HS, Kim TW, Paick SH, Jeon HS, Yang SK. Proteomic Analysis of Penile Protein Alterations in a Rat Model of Cavernous Nerve Injury. Korean J Urol 2009. [DOI: 10.4111/kju.2009.50.5.498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Hong Chung
- Department of Urology, College of Medicine, Konkuk University, Chungju, Korea
| | - Chang-Kwon Lee
- Department of Physiology, College of Medicine, Konkuk University, Chungju, Korea
| | - Bokyung Kim
- Department of Physiology, College of Medicine, Konkuk University, Chungju, Korea
| | - Hong Sup Kim
- Department of Urology, College of Medicine, Konkuk University, Chungju, Korea
| | - Tong-Wook Kim
- Department of Urology, College of Medicine, Konkuk University, Chungju, Korea
| | - Sung Hyun Paick
- Department of Urology, College of Medicine, Konkuk University, Chungju, Korea
| | - Hyun Soo Jeon
- Department of Obstetrics and Gynecology, College of Medicine, Konkuk University, Chungju, Korea
| | - Sang-Kuk Yang
- Department of Urology, College of Medicine, Konkuk University, Chungju, Korea
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Glina S, Gelbard MK, Akkus E, Jordan GH, Levine LA. Classic Citations: The use of collagenase in the treatment of Peyronie's disease M.K. Gelbard, A. Lindner, and J.J. Kaufman. J Sex Med 2007; 4:1209-13. [PMID: 17727345 DOI: 10.1111/j.1743-6109.2007.00581.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Sidney Glina
- Department of Urology, Instituto H. Ellis, São Paulo, Brazil.
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