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Modern possibilities of diagnosis and treatment of Peyronie's disease in the Czech context

Czech version

Authors: Marek Broul 1-3;  Aneta Hujová 3;  Libor Zámečník 4,5
Authors‘ workplace: Sexuologické oddělení, Krajská zdravotní, a. s. – Masarykova nemocnice v Ústí nad Labem, o. z. 1;  Urologické oddělení, Krajská zdravotní, a. s. – Nemocnice Litoměřice, o. z. 2;  Fakulta zdravotnických studií UJEP v Ústí nad Labem 3;  Sexuologický ústav 1. LF UK a VFN v Praze 4;  Urologická klinika 1. LF UK a VFN v Praze 5
Published in: Čas. Lék. čes. 2025; 164: 262-268
Category: Review Article

Overview

Peyronie's disease is an acquired fibrotic disorder of the tunica albuginea, leading to penile deformity, painful erections, and often erectile dysfunction; its prevalence in Europe reaches up to 9% in middle-aged men. This review summarizes the results of studies from 2019–2025 concerning diagnostic methods and therapeutic options.

Based on the analysis of 142 original studies, 23 meta-analyses, and current European Association of Urology (EAU) a American Urological Association (AUA) recommendations, we confirm that intralesional verapamil reduces curvature in the active phase by an average of 9–17° and low-intensity shockwave therapy (LiSWT) improves pain and reduces curvature by approximately 10°, particularly for plaques larger than 2 cm. Surgical methods –⁠ plication, incision/grafting, and penile prosthesis implantation –⁠ achieve initial straightening in more than 90% of cases but differ in impact on penile length and the risk of de novo erectile dysfunction. Regenerative therapies like platelet-rich plasma (PRP) or mesenchymal stem cells (MSC) offer promising, yet currently experimental results.

Optimal care is based on early diagnosis, individualization of conservative treatment, and precise surgical correction; in the Czech Republic, standard approaches include verapamil, LiSWT, and surgery, while biological approaches require further research.

Keywords:

regenerative medicine – Peyronie’s disease – intralesional verapamil – low intensity shock wave therapy – surgical plication – grafting – penile prosthesis

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