Peyronie's Disease: AUA Guideline

Abstract

Purpose: The purpose of this guideline is to provide a clinical framework for the diagnosis and treatment of Peyronie's disease.

Materials and 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 PD. The review yielded an evidence base of 303 articles after application of inclusion/exclusion criteria.

Results: The systematic review was used to create guideline statements regarding treatment of PD. When sufficient evidence existed, the body of evidence for a particular treatment was assigned a strength rating of A (high quality evidence; high certainty), B (moderate quality evidence; moderate certainty), or C (low quality evidence; low certainty). Evidence-based statements of Strong, Moderate, or Conditional Recommendation were developed based on benefits and risks/burdens to patients. Additional consensus statements related to the diagnosis of PD are provided as Clinical Principles and Expert Opinions due to insufficient published evidence.

Conclusions: There is a continually expanding literature on PD; the Panel notes that this document constitutes a clinical strategy and is not intended to be interpreted rigidly. The most effective approach for a particular patient is best determined by the individual clinician and patient in the context of that patient's history, values, and goals for treatment. As the science relevant to PD evolves and improves, the strategies presented here will be amended to remain consistent with the highest standards of clinical care.

Keywords: fibrosis; penile induration; penis.

Conflict of interest statement

DISCLOSURES All panel members completed COI disclosures. Relationships that have expired (more than one year old) since the panel’s initial meeting, are listed. Those marked with (C) indicate that compensation was received; relationships designated by (U) indicate no compensation was received. Consultant/Advisor: Ralph Alterowitz, MEA, The Center for Intimacy After Cancer Therapy Inc. (U); Mohit Khera, MD, Coloplast (C); American Medical Systems (C); Endo Pharmaceuticals (C); Kevin T. McVary, MD, Watson Pharmaceuticals (C), Lilly/ICOS (C), Health Publishing: Arthur L. Burnett II, MD, Urology Times Editorial Council (C); VIVUS (C); Alan W. Shindel, M.D., Endotext.com (C), International Society for Sexual Medicine (C) Leadership Position: Ralph Alterowitz, MEA, The Center for Intimacy After Cancer Therapy Inc. (U); Alan W. Shindel, M.D., Sexual Medicine Society of North America (C) Meeting Participant or Lecturer: Ralph Alterowitz, MEA, The Center for Intimacy After Cancer Therapy Inc. (U); Kevin T. McVary, MD, Watson Pharmaceuticals (C), Lilly/ICOS (C), Lawrence S. Hakim, MD, ENDO Urology (C), Slate/Auxilium (C) Scientific Study or Trial: Arthur L. Burnett II, MD, Acorda Therapeutics (C); Endo Pharmaceuticals (C); Pfizer (C); Auxilium Inc. (C); American Medical Systems (C); Coloplast (C); Astellas (C); Reflexonic LLC (C); VIVUS (C); Kevin T. McVary, MD, Astellas (C), Lilly/ICOS (C), NxThera (U), American Medical Systems (C), Sophris (C); Hossein Sadeghi-Nejad, MD, Endo Pharmaceuticals/Auxilium (C) Other: Kevin T. McVary, MD, Lilly/ICOS, Principal Investigator (C), NIDDK, Principal Investigator (C), Christian J. Nelson, PhD, American Medical Systems (U).

Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Figures

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Peyronie’s disease diagnosis and treatment algorithm