A. Hauptmann

Prospective Analysis of Single Nucleotide Polymorphisms of the Transforming Growth Factor β-1 Gene in Peyronie’s Disease

PURPOSE The detection of increased expression of transforming growth factor beta-1 (TGF-beta1) in Peyronies disease plaques and the possibility of initiating a Peyronies disease-like condition by intratunical injection of a synthetic heptopeptide with TGF-beta-like activity in an animal model has provided evidence for the central role of this cytokine in the pathogenesis of this entity. Recently 2 defined single nucleotide polymorphisms in the coding region of the TGF-beta1 gene have been described that are associated with different levels of TGF-beta1 production. Based on these data we prospectively investigated the genetic association of distinct TGF-beta1 genotypes with Peyronies disease. MATERIALS AND METHODS DNA samples from 111 consecutive patients with idiopathic Peyronies disease and 100 controls were genotyped for the 2 defined dimorphic single nucleotide polymorphisms T869C and G915C in the coding region of the TGF-beta1 gene using allele specific polymerase chain reaction. RESULTS We found an increased frequency of the homozygous genotype of the single nucleotide polymorphism G915C in patients with Peyronies disease compared with healthy controls (89.2% versus 79%, p = 0.04). However, there were no significant differences in allele frequencies of the single nucleotide polymorphism T869C. CONCLUSIONS Experimental data from other investigators have shown that TGF-beta1 has an important role in the etiopathology of Peyronies disease. Our results indicate that the homozygous wild type of the G915C single nucleotide polymorphism in the coding region of the TGF-beta1 gene, which was recently associated with elevated TGF-beta1 production and pulmonary fibrosis, may influence the predisposition to Peyronies disease. However, it does not represent a major genetic risk factor.

Induratio penis plastica (IPP)

ZusammenfassungDie Induratio penis plastica ist eine gutartige Erkrankung der Corpora cavernosa. Mikrotraumen mit nachfolgender Wundheilungsstörung unklarer Ätiologie führen durch Bildung eines unelastischen Narbengewebes im Bereich der Tunica albuginea zu den typischen Symptomen Plaquebildung, Penisschmerz, Deviation und erektile Dysfunktion. Eine kausale medikamentöse Therapie existiert nicht, obwohl vielfältige konservative Therapieoptionen einschließlich intraläsionaler Therapie diskutiert werden. Die chirurgische Korrektur der Penisverkrümmung steht häufig am Ende des Krankheitsverlaufs. Unterschiedliche Operationsverfahren werden abhängig von Deviationsgrad, Penislänge und erektiler Funktion angeboten. Diese Arbeit gibt eine Übersicht über den Krankheitsverlauf und beschreibt sowohl aktuelle konservative Therapieoptionen als auch die gängigen chirurgischen Techniken zur Deviationskorrektur.AbstractPeyronie’s disease is a benign disorder of the penis but the etiology is still unknown. A wound healing disorder after repetitive microtraumatic lesions with inelastic scar formation of the tunica albuginea potentially leads to the typical symptoms of penile plaque formation, penile pain, deviation and erectile dysfunction. A non-surgical therapy based on a clear pathophysiology does not exist although the benefit of several conservative treatment options is under discussion. In the stable stage of the disease patients with Peyronie’s disease frequently undergo penile surgery. Depending on the deviation angle, the penile length and the erectile dysfunction different straightening surgery can be performed. This article provides an overview of the natural history of the disease and describes present conservative management strategies and common surgical techniques for penile straightening.Peyronies disease is a benign disorder of the penis but the etiology is still unknown. A wound healing disorder after repetitive microtraumatic lesions with inelastic scar formation of the tunica albuginea potentially leads to the typical symptoms of penile plaque formation, penile pain, deviation and erectile dysfunction. A non-surgical therapy based on a clear pathophysiology does not exist although the benefit of several conservative treatment options is under discussion. In the stable stage of the disease patients with Peyronies disease frequently undergo penile surgery. Depending on the deviation angle, the penile length and the erectile dysfunction different straightening surgery can be performed. This article provides an overview of the natural history of the disease and describes present conservative management strategies and common surgical techniques for penile straightening.

[Treatment of azoospermia: surgical sperm retrieval (MESA, TESE, micro-TESE)].

The introduction of intracytoplasmic sperm injection (ICSI) into the spectrum of assisted reproductive technologies has offered men who suffer from severe disorders of spermatogenesis and azoospermia the possibility of fathering a child. Different surgical techniques can be used to extract spermatozoa from these men from either the epididymis and/or the testis. Surgical sperm retrieval offers a treatment for patients with testicular and/or obstructive azoospermia in cases where microsurgical refertilization is not an option or has already failed. Among surgical techniques that have been explored over the years, microsurgical epididymal sperm aspiration (MESA) and testicular sperm extraction (TESE) have become the most popular. Percutaneous techniques (such as TEFNA) are available but have disadvantages versus open surgical procedures. Together with cryopreservation of extracted spermatozoa, these techniques facilitate retrieval of spermatozoa for several ICSI attempts by a single surgical intervention.

Therapie der Azoospermie

The introduction of intracytoplasmic sperm injection (ICSI) into the spectrum of assisted reproductive technologies has offered men who suffer from severe disorders of spermatogenesis and azoospermia the possibility of fathering a child. Different surgical techniques can be used to extract spermatozoa from these men from either the epididymis and/or the testis. Surgical sperm retrieval offers a treatment for patients with testicular and/or obstructive azoospermia in cases where microsurgical refertilization is not an option or has already failed. Among surgical techniques that have been explored over the years, microsurgical epididymal sperm aspiration (MESA) and testicular sperm extraction (TESE) have become the most popular. Percutaneous techniques (such as TEFNA) are available but have disadvantages versus open surgical procedures. Together with cryopreservation of extracted spermatozoa, these techniques facilitate retrieval of spermatozoa for several ICSI attempts by a single surgical intervention.

[Peyronie's disease: diagnostics and therapy].

ZusammenfassungDie Induratio penis plastica ist eine gutartige Erkrankung der Corpora cavernosa. Mikrotraumen mit nachfolgender Wundheilungsstörung unklarer Ätiologie führen durch Bildung eines unelastischen Narbengewebes im Bereich der Tunica albuginea zu den typischen Symptomen Plaquebildung, Penisschmerz, Deviation und erektile Dysfunktion. Eine kausale medikamentöse Therapie existiert nicht, obwohl vielfältige konservative Therapieoptionen einschließlich intraläsionaler Therapie diskutiert werden. Die chirurgische Korrektur der Penisverkrümmung steht häufig am Ende des Krankheitsverlaufs. Unterschiedliche Operationsverfahren werden abhängig von Deviationsgrad, Penislänge und erektiler Funktion angeboten. Diese Arbeit gibt eine Übersicht über den Krankheitsverlauf und beschreibt sowohl aktuelle konservative Therapieoptionen als auch die gängigen chirurgischen Techniken zur Deviationskorrektur.AbstractPeyronie’s disease is a benign disorder of the penis but the etiology is still unknown. A wound healing disorder after repetitive microtraumatic lesions with inelastic scar formation of the tunica albuginea potentially leads to the typical symptoms of penile plaque formation, penile pain, deviation and erectile dysfunction. A non-surgical therapy based on a clear pathophysiology does not exist although the benefit of several conservative treatment options is under discussion. In the stable stage of the disease patients with Peyronie’s disease frequently undergo penile surgery. Depending on the deviation angle, the penile length and the erectile dysfunction different straightening surgery can be performed. This article provides an overview of the natural history of the disease and describes present conservative management strategies and common surgical techniques for penile straightening.Peyronies disease is a benign disorder of the penis but the etiology is still unknown. A wound healing disorder after repetitive microtraumatic lesions with inelastic scar formation of the tunica albuginea potentially leads to the typical symptoms of penile plaque formation, penile pain, deviation and erectile dysfunction. A non-surgical therapy based on a clear pathophysiology does not exist although the benefit of several conservative treatment options is under discussion. In the stable stage of the disease patients with Peyronies disease frequently undergo penile surgery. Depending on the deviation angle, the penile length and the erectile dysfunction different straightening surgery can be performed. This article provides an overview of the natural history of the disease and describes present conservative management strategies and common surgical techniques for penile straightening.

[News from andrology. Infertility, erectile dysfunction, and hypogonadism].

ZusammenfassungDer Beitrag bespricht neue Aspekte der Andrologie für die Schwerpunkte Infertilität, erektile Dysfunktion (ED) und Hypogonadismus. Themen wie Prostatitis und Chlamydiennachweis, idiopathische Infertilität und PDE5-Inhibitoren, ED nach Greenlight-Lasertherapie werden erörtert.AbstractThis contribution discusses new aspects in andrology focusing on infertility, erectile dysfunction (ED), and hypogonadism. Topics such as prostatitis and detection of Chlamydia, idiopathic infertility and PDE5 inhibitors, and ED after GreenLight laser treatment are addressed.This contribution discusses new aspects in andrology focusing on infertility, erectile dysfunction (ED), and hypogonadism. Topics such as prostatitis and detection of Chlamydia, idiopathic infertility and PDE5 inhibitors, and ED after GreenLight laser treatment are addressed.

Aktuelle Therapieoptionen der Induratio penis plastica@@@Current therapeutic options for Peyronie’s disease

ZusammenfassungDie Induratio penis plastica ist ein heterogenes Krankheitsbild mit den typischen penilen Symptomen: Plaquebildung, Schmerz, Deviation, Verkürzung und erektiler Dysfunktion. Die Ätiologie ist unklar. Rezidivierende Mikrotraumen werden als Ursache einer nachfolgenden, evtl. genetisch bedingten Wundheilungsstörung mit Bildung eines unelastischen Narbengewebes im Bereich der Tunica albuginea diskutiert. Eine kausale medikamentöse Therapie existiert nicht, obwohl vielfältige konservative Therapieoptionen klinisch eingesetzt werden. Die chirurgische Korrektur einer Penisverkrümmung ist bei stabilen Krankheitsverhältnissen die häufigste Therapieoption. Unterschiedliche Operationsverfahren werden abhängig vom Deviationsgrad, Penislänge und erektiler Funktion angeboten. Dieser Artikel gibt eine Übersicht über den aktuellen Stand konservativer und chirurgischer Therapieoptionen.AbstractPeyronie’s disease is a heterogeneous disorder with typical symptoms of plaque formation, penile pain, deviation, penile shortening and erectile dysfunction. The etiology is unknown. Repetitive microtraumatic lesions with the formation of inelastic scar tissue at the level of the tunica albuginea are discussed as a trigger mechanism for a questionable genetic disposition. A non-surgical therapy based on a clear pathophysiology does not exist although several conservative treatment regimes are practiced. In the stable stage of the disease surgical therapy of penile angulation is the most frequent operation. Depending on the deviation angle, penile length and erectile dysfunction, different types of straightening surgery can be offered. This article provides an overview of conservative management and commonly used surgical techniques.

[Current therapeutic options for Peyronie's disease].

ZusammenfassungDie Induratio penis plastica ist ein heterogenes Krankheitsbild mit den typischen penilen Symptomen: Plaquebildung, Schmerz, Deviation, Verkürzung und erektiler Dysfunktion. Die Ätiologie ist unklar. Rezidivierende Mikrotraumen werden als Ursache einer nachfolgenden, evtl. genetisch bedingten Wundheilungsstörung mit Bildung eines unelastischen Narbengewebes im Bereich der Tunica albuginea diskutiert. Eine kausale medikamentöse Therapie existiert nicht, obwohl vielfältige konservative Therapieoptionen klinisch eingesetzt werden. Die chirurgische Korrektur einer Penisverkrümmung ist bei stabilen Krankheitsverhältnissen die häufigste Therapieoption. Unterschiedliche Operationsverfahren werden abhängig vom Deviationsgrad, Penislänge und erektiler Funktion angeboten. Dieser Artikel gibt eine Übersicht über den aktuellen Stand konservativer und chirurgischer Therapieoptionen.AbstractPeyronie’s disease is a heterogeneous disorder with typical symptoms of plaque formation, penile pain, deviation, penile shortening and erectile dysfunction. The etiology is unknown. Repetitive microtraumatic lesions with the formation of inelastic scar tissue at the level of the tunica albuginea are discussed as a trigger mechanism for a questionable genetic disposition. A non-surgical therapy based on a clear pathophysiology does not exist although several conservative treatment regimes are practiced. In the stable stage of the disease surgical therapy of penile angulation is the most frequent operation. Depending on the deviation angle, penile length and erectile dysfunction, different types of straightening surgery can be offered. This article provides an overview of conservative management and commonly used surgical techniques.

Aktuelle Therapieoptionen der Induratio penis plastica

ZusammenfassungDie Induratio penis plastica ist ein heterogenes Krankheitsbild mit den typischen penilen Symptomen: Plaquebildung, Schmerz, Deviation, Verkürzung und erektiler Dysfunktion. Die Ätiologie ist unklar. Rezidivierende Mikrotraumen werden als Ursache einer nachfolgenden, evtl. genetisch bedingten Wundheilungsstörung mit Bildung eines unelastischen Narbengewebes im Bereich der Tunica albuginea diskutiert. Eine kausale medikamentöse Therapie existiert nicht, obwohl vielfältige konservative Therapieoptionen klinisch eingesetzt werden. Die chirurgische Korrektur einer Penisverkrümmung ist bei stabilen Krankheitsverhältnissen die häufigste Therapieoption. Unterschiedliche Operationsverfahren werden abhängig vom Deviationsgrad, Penislänge und erektiler Funktion angeboten. Dieser Artikel gibt eine Übersicht über den aktuellen Stand konservativer und chirurgischer Therapieoptionen.AbstractPeyronie’s disease is a heterogeneous disorder with typical symptoms of plaque formation, penile pain, deviation, penile shortening and erectile dysfunction. The etiology is unknown. Repetitive microtraumatic lesions with the formation of inelastic scar tissue at the level of the tunica albuginea are discussed as a trigger mechanism for a questionable genetic disposition. A non-surgical therapy based on a clear pathophysiology does not exist although several conservative treatment regimes are practiced. In the stable stage of the disease surgical therapy of penile angulation is the most frequent operation. Depending on the deviation angle, penile length and erectile dysfunction, different types of straightening surgery can be offered. This article provides an overview of conservative management and commonly used surgical techniques.

Induratio penis plastica (IPP)@@@Peyronie’s disease: Diagnostik und Therapie@@@Diagnostics and therapy

ZusammenfassungDie Induratio penis plastica ist eine gutartige Erkrankung der Corpora cavernosa. Mikrotraumen mit nachfolgender Wundheilungsstörung unklarer Ätiologie führen durch Bildung eines unelastischen Narbengewebes im Bereich der Tunica albuginea zu den typischen Symptomen Plaquebildung, Penisschmerz, Deviation und erektile Dysfunktion. Eine kausale medikamentöse Therapie existiert nicht, obwohl vielfältige konservative Therapieoptionen einschließlich intraläsionaler Therapie diskutiert werden. Die chirurgische Korrektur der Penisverkrümmung steht häufig am Ende des Krankheitsverlaufs. Unterschiedliche Operationsverfahren werden abhängig von Deviationsgrad, Penislänge und erektiler Funktion angeboten. Diese Arbeit gibt eine Übersicht über den Krankheitsverlauf und beschreibt sowohl aktuelle konservative Therapieoptionen als auch die gängigen chirurgischen Techniken zur Deviationskorrektur.AbstractPeyronie’s disease is a benign disorder of the penis but the etiology is still unknown. A wound healing disorder after repetitive microtraumatic lesions with inelastic scar formation of the tunica albuginea potentially leads to the typical symptoms of penile plaque formation, penile pain, deviation and erectile dysfunction. A non-surgical therapy based on a clear pathophysiology does not exist although the benefit of several conservative treatment options is under discussion. In the stable stage of the disease patients with Peyronie’s disease frequently undergo penile surgery. Depending on the deviation angle, the penile length and the erectile dysfunction different straightening surgery can be performed. This article provides an overview of the natural history of the disease and describes present conservative management strategies and common surgical techniques for penile straightening.Peyronies disease is a benign disorder of the penis but the etiology is still unknown. A wound healing disorder after repetitive microtraumatic lesions with inelastic scar formation of the tunica albuginea potentially leads to the typical symptoms of penile plaque formation, penile pain, deviation and erectile dysfunction. A non-surgical therapy based on a clear pathophysiology does not exist although the benefit of several conservative treatment options is under discussion. In the stable stage of the disease patients with Peyronies disease frequently undergo penile surgery. Depending on the deviation angle, the penile length and the erectile dysfunction different straightening surgery can be performed. This article provides an overview of the natural history of the disease and describes present conservative management strategies and common surgical techniques for penile straightening.