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Skjev penis

Sist revidert:
Sist revidert av:
Definisjon:
Medfødt krumning av penis kalles krummerik, ervervet krumning kalles induratio penis plastica. Den ervervede varianten er vanlig og skyldes fibrosedannelse
Forekomst:
Krummerik er en sjelden tilstand. Induratio penis plastica forekommer hos kanskje så mange som 10%, og forekomsten øker med alderen
Symptomer:
Kan være smerter eller ubehag ved samleie, ev. ereksjonsproblemer
Funn:
Tilstanden er lettest å vurdere ved ereksjon. Ved induratio penis plastica kan man som regel palpere ømme knuter/plakk på samme siden som kurvaturen
Diagnostikk:
Hjemmefoto av erigert penis i flere vinklinger er til stor nytte, ev. direkte observasjon etter injeksjon av vasoaktivt medikament. Duplex Doppler ultralyd av penis brukes til å lokalisere plakk
Behandling:
Medikamentell behandling har usikker virkning. Injeksjonsbehandling med kollagenase kan forsøkes, men Xiapex er avregistrert. Flere varianter av kirurgisk behandling kan være aktuelt.
  1. Svendsen K-OB, Schultz A. Seksuell dysfunksjon hos menn. Tidsskr Nor Legeforen 2008; 128: 448-52. Tidsskrift for Den norske legeforening  
  2. Chung PH, Han TM, Rudnik B, Das AK. Peyronie's disease: what do we know and how do we treat it?. Can J Urol. 2020;27(S3):11-19. PMID: 32875997 PubMed  
  3. Wan J, Rew KT. Common penile problems. Prim Care 2010; 37: 627-42. PubMed  
  4. Mulhall JP, Alex B, Choi JM. Predicting delay in presentation in men with Peyronie's disease. J Sex Med 2010; 7: 2226-30. PubMed  
  5. Ralph D, Gonzalez-Cadavid N, Mirone V, et al. The management of Peyronie's disease: evidence-based 2010 guidelines. J Sex Med 2010; 7: 2359-74. PubMed  
  6. LaRochelle JC, Levine LA. A survey of primary care physicians and urologists regarding Peyronie`s disease. J Sex Med 2007; 4: 1167-73. PubMed  
  7. Ziegelmann MJ, Bajic P, Levine LA. Peyronie's disease: Contemporary evaluation and management. Int J Urol. 2020;27(6):504-516. PubMed  
  8. Serefoglu EC, Hellstrom WJ.. Treatment of Peyronie's disease: 2012 update. Curr Urol Rep 2011; 12: 444-52. PubMed  
  9. Brant WO, Bella AJ, Lue TF. Peyronie's disease: Diagnosis and medical management. UpToDate, last updated Jul 26, 2021. www.uptodate.com  
  10. Larsen SM, Levine LA. Review of non-surgical treatment options for Peyronie's disease. Int J Impot Res 2012; 24: 1-10. PubMed  
  11. Larsen SM, Levine LA. Peyronie's disease: review of nonsurgical treatment options. Urol Clin North Am 2011; 38: 195-205. PubMed  
  12. 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: 199-207. pmid:23376148 PubMed  
  13. Nguyen HMT, Yousif A, Chung A, et al. Safety and Efficacy of Collagenase Clostridium histolyticum in the Treatment of Acute Phase Peyronie's Disease: A Multi-institutional Analysis. Urology 2020; 145:147. PubMed  
  14. Russo GI, Milenkovic U, Hellstrom W et al. Clinical Efficacy of Injection and Mechanical Therapy for Peyronie's Disease: A Systematic Review of the Literature. Eur Urol 2018. pmid:30237020 PubMed  
  15. Inal T, Tokatli Z, Akand M, et al. Effect of intralesional interferon-alpha 2b combined with oral vitamin E for treatment of early stage Peyronie's disease: a randomized and prospective study. Urology 2006; 67: 1038-42. PubMed  
  16. Russel S, Steers W, McVary KT. Systematic evidence-based analysis of plaque injection therapy for Peyronie's disease. Eur Urol 2007; 51: 640. pmid:17092631 PubMed  
  17. Kadioglu A, Küçükdurmaz F, Sanli O. Current status of the surgical management of Peyronie's disease. Nat Rev Urol 2011; 8: 95-106. PubMed  
  18. Chung E, Clendinning E, Lessard L et al: Five-year follow-up of Peyronie’s graft surgery: outcomes and patient satisfaction. J Sex Med 2010; 8: 594. PubMed  
  19. Palmieri A, Imbimbo C, Longo N, et al. A first prospective, randomized, double-blind, placebo-controlled clinical trial evaluating extracorporeal shock wave therapy for the treatment of Peyronie's disease. Eur Urol 2009; 56: 363-9. PubMed  
  20. Greenfield JM, Shah SJ, Levine LA. Verapamil versus saline in electromotive drug administration for Peyronie's disease: a double-blind, placebo controlled trial. J Urol 2007; 177: 972-5. PubMed  
  21. Vernet D, Nolazco G, Cantini L, et al. Evidence that osteogenic progenitor cells in the human tunica albuginea may originate from stem cells: implications for peyronie disease. Biol Reprod 2005; 73: 1199-210. PubMed  
  22. Mulhall JP, Schiff J, Guhring P. An analysis of the natural history of Peyronie's disease. J Urol 2006; 175: 2115-8. PubMed  
  23. Chung E, Clendinning E, Lessard L, Brock G. Five-year follow-up of Peyronie's graft surgery: outcomes and patient satisfaction. J Sex Med 2011; 8: 594-600. PubMed  
  24. Levine LA, Benson J, Hoover C. Inflatable penile prosthesis placement in men with Peyronie`s disease and drug-resistant erectile dysfunction. J Sex Med 2010; 7: 3775-83. PubMed  
  25. Abdel-Hamid IA, Anis T. Peyronie's disease: perspectives on therapeutic targets. Expert Opin Ther Targets 2011; 15: 913-29. PubMed  
  26. Jordan GH. The use of intralesional clostridial collagenase injection therapy for Peyronie's disease: a prospective, single-center, non-placebo-controlled study. J Sex Med 2008; 5: 180-7. PubMed  
  27. European Medicines Agency. Summary of opinion: Xiapex - collagenase clostridium histolyticum. 18 December 2014. www.ema.europa.eu  
  28. Soh J, Kawauchi A, Kanemitsu N, et al. Nicardipine vs. saline injection as treatment for Peyronie's disease: a prospective, randomized, single-blind trial. J Sex Med 2010; 7: 3743-9. PubMed  
  29. Peyronie's Disease: Nonsurgical Therapy Options. Kuehhas FE, Weibl P, Georgi T, et al. Rev Urol 2011; 13: 139-46. PubMed  
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Steinar J. Karlsen, tidligere klinikksjef og professor dr. med., Oslo Urologiske Universitetsklinikk, Aker universitetssykehus helseforetak og Universitetet i Oslo
  • Svein Z. Bratland, spesialist i allmennmedisin, Sandviken Legesenter, Bergen, og seniorrådgiver i Statens helsetilsyn, Oslo
  • Per Inge Lundmo, overlege Kirurgisk klinikk, Urinveissykdommer, Regionsykehuset i Trondheim og førsteamanuensis Norges teknisk-naturvitenskapelige universitet, Trondheim