Jozef Marenčák
Induratio penis plastica (IPP, Peyronie´s disease) is a connective tissue disorder, characterised by the formation of a fibrotic
lesion or plaque in the tunica albuginea, which leads to penile deformity. Prevalence rates of 0.4 – 9 % have been
published. The aetiology of IPP is unknown. The contribution of associated comorbidities or risk factors (e. g. diabetes
mellitus, hypertension, lipid abnormalities and Dupuytren´s contracture) to the pathophysiology of Peyronie´s disease
is still unclear. Two phases of the disease can be distinguished. The first phase is the acute inflammatory phase (painful
erections, „soft“ nodule/ plaque), and the second phase is the fibrotic/calcifying phase with formation of hard palpable
plaques (disease stabilisation). Spontaneous resolution is uncommon (3 – 13 %) and most patients experience disease
progression (30 – 50 %) or stabilisation (47 – 67 %). Pain is usually present during the early stages of the disease but
tends to resolve with time in 90 % of men. Conservative treatment for Peyronie´s disease is primarily aimed at treating
patients in the early stage of the disease. It is an option in patients not fit for surgery or when surgery is not acceptable
to the patient. In this context, several options have been suggested, including oral pharmacotherapy, intralesional injection
therapy and other topical treatments, which will be discussed in detail in this review en_article. The role of conservative
treatment in men with stable/chronic disease has not been adequately defined yet. No a single drug has been approved
(grade A recommendation) by the European Medical Association for the therapy of this relatively rare disease.