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Peyronie’s disease (induratio penis plastica) –⁠ contemporary perspective on diagnosis and management in Czech clinical practice


Authors: Petra Kučerová 1,2;  Jan Schraml 1
Authors‘ workplace: Klinika urologie a robotické chirurgie, Krajská zdravotní, a. s. – Masarykova nemocnice v Ústí nad Labem, o. z. 1;  Sexuologické oddělení, Krajská zdravotní, a. s. – Masarykova nemocnice v Ústí nad Labem, o. z. 2
Published in: Ces Urol 2026; 30(3): 119-125
Category: Review article
doi: https://doi.org/10.48095/cccu2026017

Overview

Introduction and objective: Peyronie’s disease is an acquired fibrotic disorder of the tunica albuginea causing penile deformity, pain during erection, penile shortening and frequently erectile dysfunction (ED). The disease has a substantial psychosexual impact on both the patient and the partner. The aim of this narrative review is to summarize contemporary diagnosis and management of Peyronie’s disease with emphasis on practical decision-making in Czech urological, andrological and sexological practice. Methods: We conducted a narrative review based on the 2026 European Association of Urology guidelines, the American Urological Association guideline, the Fifth International Consultation on Sexual Medicine 2024 recommendations, systematic reviews and a targeted PubMed/MEDLINE search, with additional consideration of Czech literature. Results: Diagnosis is based on history, plaque palpation, objective assessment of erect penile deformity and evaluation of erectile function and psychosexual burden using validated instruments, particularly the Peyronie’s Disease Questionnaire and the International Index of Erectile Function. Doppler ultrasonography is useful mainly in men with ED, plaque calcification and before invasive treatment; magnetic resonance imaging is not recommended routinely. Management is phase-adapted –⁠ in the active phase, counselling, pain control, ED treatment, penile traction therapy, vacuum therapy, extracorporeal shockwave treatment for pain and selected intralesional therapy may be used. Collagenase Clostridium histolyticum has demonstrated efficacy but has not been available in Europe since 2020. Surgery remains central for stable, function-limiting deformity. Conclusions: Successful management requires objective documentation of deformity, realistic counselling, ED treatment, attention to psychosexual distress and appropriate timing of surgical correction.

Keywords:

Erectile dysfunction – Peyronie’s disease – penile curvature – penile traction therapy – intralesional therapy – penile surgery


Sources

1. Salonia A, Boeri L, Capogrosso P et al. EAU Guidelines on sexual and reproductive health. Limited update March 2026. Arnhem: European Association of Urology 2026. Available from: https://uroweb.org/guidelines/sexual-and-reproductive-health.

2. Patel DP, Christensen MB, Hotaling JM et al. A review of inflammation and fibrosis: implications for the pathogenesis of Peyronie’s disease. World J Urol 2020; 38(2): 253–261. doi: 10.1007/s00345-019-02815-6.

3. Mitsui Y, Yamabe F, Hori S et al. Molecular mechanisms and risk factors related to the pathogenesis of Peyronie’s disease. Int J Mol Sci 2023; 24(12): 10133. doi: 10.3390/ijms241210133.

4. Baethge C, Goldbeck-Wood S, Mertens S. SANRA –⁠ a scale for the quality assessment of narrative review articles. Res Integr Peer Rev 2019; 4 : 5. doi: 10.1186/s41073-019-0064-8.

5. Nehra A, Alterowitz R, Culkin DJ et al. Peyronie’s disease: AUA guideline. J Urol 2015; 194(3): 745–753. doi: 10.1016/j.juro.2015.05.098.

6. Chung E, Ziegelmann M, Lin HC et al. Management of Peyronie’s disease: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024). Sex Med Rev 2026; 14(1): qeaf068. doi: 10.1093/sxmrev/qeaf068.

7. Rosenberg JE, Ergun O, Hwang EC et al. Non-surgical therapies for Peyronie’s disease. Cochrane Database Syst Rev 2023; 7(7): CD012206. doi: 10.1002/14651858.CD012206.pub2.

8. Hayat S, Brunckhorst O, Alnajjar HM et al. A systematic review of non-surgical management in Peyronie’s disease. Int J Impot Res 2023; 35(6): 523–532. doi: 10.1038/s41443-022-00633-w.

9. Manfredi C, Russo GI, Capogrosso P et al. Injection therapy in the acute phase of Peyronie’s disease: a systematic review of current evidence. J Sex Med 2025; 22(5): 799–812. doi: 10.1093/jsxmed/qdaf044.

10. Natsos A, Tatanis V, Kontogiannis S et al. Grafts in Peyronie’s surgery without the use of prostheses: a systematic review and meta-analysis. Asian J Androl 2024; 26(3): 250–259. doi: 10.4103/aja202358.

11. Sokolakis I, Pyrgidis N, Ziegelmann MJ et al. Penile prosthesis implantation combined with grafting techniques in patients with Peyronie’s disease and erectile dysfunction: a systematic review. Sex Med Rev 2022; 10(3): 451–459. doi: 10.1016/j.sxmr.2021.03.007.

12. Horák A. Peyronieho choroba. Ces Urol 2017; 21(1): 43–58. doi: 10.48095/cccu2017004.

13. Marenčák J. Induratio penis plastica. Urol Praxi 2020; 21(3): 113 –118. doi: 10.36290/uro.2020.023.

14. Čapka D, Grill R. Peyronieho choroba –⁠ dnešní možnosti léčby. Urol Praxi 2021; 22(3): 143–147. doi: 10.36290/uro.2020.056.

15. Broul M, Hujová A, Zámečník L. Moderní možnosti diagnostiky a léčby Peyronieho choroby v českém kontextu. Čas Lék Čes 2025; 164(6): 262–268.

16. Punjani N, Nascimento B, Salter C et al. Predictors of depression in men with Peyronie’s disease seeking evaluation. J Sex Med 2021; 18(4): 783–788. doi: 10.1016/j.jsxm.2021.02.002.

17. Nelson CJ, Mulhall JP. Psychological impact of Peyronie’s disease: a review. J Sex Med 2013; 10(3): 653–660. doi: 10.1111/j.1743-6109.2012.02999.x.

18. Hellstrom WJG, Feldman R, Rosen RC et al. Bother and distress associated with Peyronie’s disease: validation of the Peyronie’s Disease Questionnaire. J Urol 2013; 190(2): 627–634. doi: 10.1016/j.juro.2013.01.090.

19. Davis SN, Ferrar S, Sadikaj G et al. Female partners of men with Peyronie’s disease have impaired sexual function, satisfaction, and mood. J Sex Med 2016; 13(7): 1095–1103. doi: 10.1016/j.jsxm.2016.04.074.

20. García-Gómez B, Aversa A, Alonso-Isa M et al. The use of penile traction devices for Peyronie’s disease: position statements from the European Society for Sexual Medicine. Sex Med 2021; 9(4): 100387. doi: 10.1016/j.esxm.2021.100387.

21. Ziegelmann MJ, Savage JB, Toussi A et al. Outcomes of a novel penile traction device in men with Peyronie’s disease: a randomized, single-blind, controlled trial. J Urol 2019; 202(3): 599–610. doi: 10.1097/JU.0000000000000245.

22. Li G, Xu X, Man L. Low-intensity extracorporeal shock wave therapy for Peyronie’s disease: a systematic review and meta-analysis. BMC Urol 2024; 24(1): 217. doi: 10.1186/s12894-024-01607-4.

23. Broul M, Hokůvová P, Schraml J. Zkušenosti s aplikací verapamilu do plaku u pacientů s induratio penis plastica –⁠ morbus Peyronie. Urol Praxi 2018; 19(1): 29–32. doi: 10.36290/uro.2018.049.

24. Roth BJ, Hammad MAM, Sultan MI et al. Hyaluronic acid and urology: a systematic review and meta-analysis. Sex Med Rev 2025; 13(1): 52–61. doi: 10.1093/sxmrev/qeae060.

25. Asmundo MG, Durukan E, von Rohden E et al. Platelet-rich plasma therapy in erectile dysfunction and Peyronie’s disease: a systematic review of the literature. World J Urol 2024; 42(1): 359. doi: 10.1007/s00345-024-05065-3.

26. Gelbard M, Goldstein I, Hellstrom WJ et al. Clinical efficacy, safety and tolerability of collagenase Clostridium histolyticum for the treatment of Peyronie disease in 2 large double-blind, randomized, placebo-controlled phase 3 studies. J Urol 2013; 190(1): 199–207. doi: 10.1016/j.juro.2013.01.087.

27. Cocci A, Russo GI, Martinez Salamanca JI et al. The end of an era: withdrawal of Xiapex (Clostridium histolyticum collagenase) from the European market. Eur Urol 2020; 77(5): 660–661. doi: 10.1016/j.eururo.2019.11.019.

Labels
Paediatric urologist Nephrology Urology

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Czech Urology

Issue 3

2026 Issue 3

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