Peyronie's Disease: American Urological AssociationSearched before posting, and didn't seem to find anything about it, so think it's not a repost. Super up to date, and from a reputable source, IMO. Hope not to be wrong.
"Purpose: The purpose of this guideline is to provide a clinical framework for the diagnosis and treatment of Peyronie's disease (Peyronies Disease).Methods: A systematic review of the literature using the Pubmed, Embase, and Cochrane databases (search dates 1/1/1965 to 1/26/15) was conducted to identify peer-reviewed publications relevant to the diagnosis and treatment of Peyronies Disease. The review yielded an evidence base of 303 articles after application of inclusion/exclusion criteria. [...]
Diagnosis1. Clinicians should engage in a diagnostic process to document the signs and symptoms that characterize Peyronie's disease. The minimum requirements for this examination are a careful history (to assess penile deformity, interference with intercourse, penile pain, and/or distress) and a physical exam of the genitalia (to assess for palpable abnormalities of the penis). (Clinical Principle)
2. Clinicians should perform an in-office intracavernosal injection (ICI) test with or without duplex Doppler ultrasound prior to invasive intervention. (Expert Opinion)
3. Clinicians should evaluate and treat a man with Peyronie's disease only when he has the experience and diagnostic tools to appropriately evaluate, counsel, and treat the condition. (Expert Opinion)
Treatment4. Clinicians should discuss with patients the available treatment options and the known benefits and risks/burdens associated with each treatment. (Clinical Principle)
5. Clinicians may offer oral non-steroidal anti-inflammatory medications to the patient suffering from active Peyronie's disease who is in need of pain management.
6. Clinicians should not offer oral therapy with vitamin E, tamoxifen, procarbazine, omega-3 fatty acids, or a combination of vitamin E with L-carnitine. [Moderate Recommendation; Evidence Strength Grade B(vitamin E/omega-3 fatty acids/Vitamin E + propionyl-L-carnitine )/ C( tamoxifen/procarbazine)]
7. Clinicians should not offer electromotive therapy with
verapamil. (Moderate Recommendation; Evidence Strength Grade C)
8. Clinicians may administer intralesional
collagenase clostridium histolyticum in combination with modeling by the clinician and by the patient for the reduction of penile curvature in patients with stable Peyronie's disease, penile curvature >30° and <90°, and intact erectile function (with or without the use of medications). (Moderate Recommendation; Evidence Strength Grade B)
9. Clinicians should counsel patients with Peyronie's disease prior to beginning treatment with intralesional
collagenase regarding potential occurrence of adverse events, including penile ecchymosis, swelling, pain, and corporal rupture. (Clinical Principle)
10. Clinicians may administer intralesional interferon α-2b in patients with Peyronie's disease. (Moderate Recommendation; Evidence Strength Grade C)
11. Clinicians should counsel patients with Peyronie's disease prior to beginning treatment with intralesional interferon a-2b about potential adverse events, including sinusitis, flu-like symptoms, and minor penile swelling. (Clinical Principle)
12. Clinicians may offer intralesional
verapamil for the treatment of patients with Peyronie's disease. (Conditional Recommendation; Evidence Strength Grade C)
13. Clinicians should counsel patients with Peyronie's disease prior to beginning treatment with intralesional
verapamil about potential adverse events, including penile bruising, dizziness, nausea, and pain at the injection site. (Clinical Principle)
14. Clinicians should not use extracorporeal shock wave therapy (
ESWT) for the reduction of penile curvature or
plaque size. (Moderate Recommendation; Evidence Strength Grade B)
15. Clinicians may offer extracorporeal shock wave therapy (
ESWT) to improve penile pain. (Conditional Recommendation; Evidence Strength Grade B)
16. Clinicians should not use radiotherapy (RT) to treat Peyronie's disease. (Moderate Recommendation; Evidence Strength Grade C)
17. Clinicians should assess patients as candidates for surgical reconstruction based on the presence of stable disease. (Clinical Principle)
18. Clinicians may offer tunical plication surgery to patients whose rigidity is adequate for coitus (with or without pharmacotherapy and/or vacuum device therapy) to improve penile curvature. (Moderate Recommendation; Evidence Strength Grade C)
19. Clinicians may offer
plaque incision or excision and/or grafting to patients with deformities whose rigidity is adequate for coitus (with or without pharmacotherapy and/or vacuum device therapy) to improve penile curvature. (Moderate Recommendation; Evidence Strength Grade C)
20. Clinicians may offer penile
prosthesis surgery to patients with Peyronie's disease with
erectile dysfunction (
Erectile Dysfunction) and/or penile deformity sufficient to prevent coitus despite pharmacotherapy and/or vacuum device therapy. (Moderate Recommendation; Evidence Strength Grade C)
21. Clinicians may perform adjunctive intra-operative procedures, such as modeling, plication or incision/grafting, when significant penile deformity persists after insertion of the penile
prosthesis. (Moderate Recommendation; Evidence Strength Grade C)
22. Clinicians should use inflatable penile
prosthesis for patients undergoing penile prosthetic surgery for the treatment of Peyronie's
disease. (Expert Opinion)
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Topic: American Urological Association - 2015 Guidelines for Peyronies (Read 1775 times)
January 20, 2016, 06:24:09 PM