Peyroni ' s disease is the indulgation of a fibroplastic sexual member (lat. induratio - validation, sealing, fibra - fibroke), a condition with a predominant localization of the pathological process in the caveal bodies of a member of the sex, leading to his deformation during the erection.
Among the diseases of the male sex system, Peyroni ' s disease is one of the leading places, despite its low prevalence of 0.3 per cent to 1 per cent.
Peyroni ' s disease, or the fibroplastic indulgence of a sexual member, is characterized by the formation of tight drums in the white shell of corrosive bodies, causing painful erections, curing penis in erection, reducing his rhygies, resulting in sexual dissatisfaction and deep psychological trauma.
For the first time, this state described Francois Gigot de la Peyronie, founder of the Paris surgical academy, who, in 1743, observed three patients with a clear-cut tissue, the result of which was the upward sparkling of the penis during the erection. Peyroni ' s disease is most commonly affecting men between 40 and 60 years of age, and the average age is 53 years, but sometimes occurs at older or younger ages. Ethology and pathogenes of the present disease are largely unambiguous. The microwaves of the white shell are now important. Hemorrhage is expected as a result of fractures of thin blood vessels, following which the calcium salts are fibrously reborn. Gistogenes, clinical manifestations of fibroplastic induction of a sexual member have much in common with pathological processes related to the group of collagines. All researchers, starting with Peyronie, Wesson, Rovinesco, Wegenknecht, Kolle, et al. consider Peyroni disease as a polyethyological disease whose development role is traumatic, inflammatory, genetic and immunological.
The most common symptoms of Peyroni ' s disease are the existence of a palpable head -78-100%, sexual spark - 52-100%, and painful erections - 70 percent. The size of the drums ranges from several millimetres to several centimetres and averages between 1.5 and 2 centimetres. Depending on the localization of the eyebrows, the dorsal, ventral and lateral spray of the penis is different.
In the nineteenth century, iodine, arsenic, camphorus were used to treat Peyroni's disease. Later, radio therapy, short-wave diagnostics, laser therapy and litotripsy were used for this purpose. The oral therapy has been applied since 1948, when Scott and Scardino started using vitamin E (tocoferola acetat) to treat Peyroni. Katz-Galatzi, Chauvin and Silvan used this drug both independently and for integrated therapy. On the other hand, Ashworth and Bystrom reported inefficiencies in the use of tocoferols, but vitamin E is still in use. Biogenic stimulants and enzymes - lydasis, ronidasis, tyomasis, were also used to treat Peyroni ' s disease through injection or electrophoresis.
Gelbard and co-author examined the influence of enzymes on the connective tissue, both healthy and pathologically modified; in both cases, collagine fibres were dissolved, but the dose of the drug for effects only on the affected section of the white casing was not clarified. Also, fermental drugs have a significant disadvantage - an immune response, up to anaphylactic shock. Ralth and co-auth described the experience with the use of the oral Tamoxifen in 1992. A preliminary study had shown encouraging results for patients with a short period of disease - less than four months. Reception mode - 20 mg tampoxyphen 2 times a day for 3 months. 80 per cent of patients reported a reduction in the disease symptom, 35 per cent a decrease in deformation, 34 per cent reported a decrease in the head. The oral therapy of colchicin was described in the open study of Akkus and saut. This substance increases the activity of the collaginaza and thus reduces the synthesis of the collagina. As a result, 11 per cent of the tested have slightly regressed the penis curvature, and 26 per cent have seen a marked reduction in the erectile deformation. In 1954, Tesley offered the oral and local use of steroids based on their anti-inflammatory properties to treat the Peyroni disease. However, the complications of local use of steroids (bone symptom, microgemat and refibration sites) restricted the widespread use of the technique.
Winter and Khanna published in 1954 the results of their study on the effectiveness of local dxamethazone injections (Dermo-jet). There was a decrease in the size of the head and pain in the erection, but no statistically valid difference was found compared to the control group. However, this method has since been widely disseminated. In 1980, Williams and Green reported the use of triamcinolone (local injections). The study described surveillance, not included in the official report, when the patient had a kidney deficiency due to overuse of steroid injections. Injecting steroids may also create obstacles to further surgical treatment, as it is very difficult to separate tissues between the Buka phase and the white shell.
The calcium antagonist, the verapamil, was first used for local use in 1994. Twenty-seven patients were involved in the study. Subjectively 96% noted the rapid regression of the disease symptom. Penitentiary deformation decreased from 85 per cent, increased, rhygidration increased from 74 per cent and sexual satisfaction increased in 89 per cent of all cases. The objective study included a doppic ultrasonic pre- and post-treatment study, which showed a decrease in curves of 61 per cent with an average value of 220 (10-400). Greenev A.V. and soavt report the successful use of vrapamyl in 11 patients with disease syndrome. Verapamill was introduced into fibrous drums in a dosage of 10 mg in 10 ml of isotonic solution once every two weeks to 10 sessions. As a result, all the patients, including a patient with calcification of fibrous drums, were bathed on average after the fourth procedure. The decrease in the size of the headaches was on average 40 per cent, excluding the above-mentioned patient. Sensitization of the sexual member decreased by an average of 35 per cent.
Peyroni ' s disease is being treated with many physiotherapy techniques - X-ray therapy, radiotherapy, although its application is now limited by a large number of side effects (bottoms, leather bleaching, erectyl dysfunction, sexual fermentation, mesenchemical metal methoplasics, which are further developed with fibrous, cartilization). The literature describes the use of electronic beam, diadynamic currents, diatermis, dirt, hystamine electrophoresis, lydazine, glucorticides, helium neon laser.
Good results are found in ultrasonic therapy, which is based on accelerated biochemical reactions and vibration tissue masses. There is also a combination of ultrasonic treatment with the use of drugs (butadione, hydrocortisone, vitamin E). Most authors note the good dehydration effect of treatment, the absence of side effects, the reduction of the size of the fibrous head of some patients. However, no patient was detected with full scattering of the head and regression of penis.
Pharmaceuticals such as aminopropyonitryl (collagine connection ingifier), interferones, orgotine (oppressive metalprotein), parathyroid hormones are located in I and II phases of clinical testing, and the effectiveness and safety of the use of these drugs and substances is not yet available. The effectiveness of conservative therapy is low and positive results are found in 10 to 25 per cent of patients, but despite this, many authors point to the need for conservative therapy both in monotherapy and in combination with operational treatment.
If there's no erection, a sexual member of the normal configuration. During the erection, his sparkling is taking place, accompanied by moderate pains in a puberty who disappear with erection. In some cases, severe organ deformation and pain generally exclude sexual contact. Libido and erection are gradually declining, which is painful and often leads to neurotic conditions.
The diagnosis of fibroplastic indulgence of a sexual member is not difficult, as cartilage seals can easily be found on the rear surface. However, X-ray and ultrasonic research methods are used in some cases to determine the extent of the process, the condition of caveal bodies and the surrounding tissues of neighbouring tissues. Long-term infection. It is possible to treat in a period of general exposure to organisms and local exposure to indulgent settings, including vitamins, desensitizing means, biostimulants, hormones dispersing drugs (directly in the vicinity). Physiotherapy procedures also prevent the development of seals and promote dispersal.
At the time of the stabilization of the rubber process, when a purely sexual bias occurs, there is a need for adaptive sexual activity skills (gathering of positions and positions, and training of partners to reduce the time it reaches orgasm).
In cases of unsuccessful conservative treatment or instability, its effect has been shown by rapid treatment. Even after surgical treatment, the prognosis is not always favourable because the disease tends to relapse.