3rd Annual Jefferson Urology Symposium: Men’s Health Forum

© The Canadian Journal of Urology TM : International Supplement, August 2020 Autologous platelet rich plasma Autologous platelet rich plasma (PRP) injection have been used in other medical therapies and may be effective for use in PD by improving angiogenesis and woundhealing. However, one concernwithPRP is early washout, which may be avoided by using platelet rich fibrin matrix. In a preliminary study to assess safety and feasibility of platelet rich fibrin matrix injections for treatment of urologic conditions including PD, Matz et al reviewed data in 17 patients with a mean receipt of 2.1 injections per patient. 56 Of the 17 patients, 11 had PD with PRP injected with ultrasound into the plaque. While sample sizes were very small, 80% (4/5) PD patients with subsequent follow up (overall mean 15.5 months) reported subjective improvement in curvature. Adverse events in all 17 patients included mild pain (23.5%) and bruising (5.9%). To date, there exists only this one study exploring this therapy. As for stem cell therapy in treatment of PD, there have been promising published results, but only involving rat models. 57,58 Conclusion PD is a common condition that can potentially result in physical, emotional, and/or psychological distress. Patients may be embarrassed to seek professional help or may be unaware of their available treatment options. As a result, patients may not discuss their signs or symptoms unless directly asked. For these reasons, PD is likely underdiagnosed and therefore undertreated. Urologists should become comfortable withdiscussing andmanaging these issueswithpatients in order to properly diagnose patients, educate themon disease progression and timeline, target treatment goals, reach a shared decision regarding possible treatment, and manage expectations. Treatment options offered may vary based on practice resources and surgeon experience. In fact, due to the complex nature of managing and treating PD, the role may be best suited for experts with appropriate and specific experience, tools, and surgical skillset. As newmedical and surgical treatments are being studied, the landscape of PD management may continue to evolve and should target themaximizing of patient satisfactionwhileminimizing adverse events. References 1. Dibenedetti DB, Nguyen D, Zografos L, Ziemiecki R, Zhou X. A population-based study of Peyronie’s disease: prevalence and treatment patterns in the United States. Adv Urol 2011;2011:282503. 2. Arafa M, Eid H, El-Badry A, Ezz-Eldine K, Shamloul R. The prevalence of Peyronie’s disease in diabetic patients with erectile dysfunction. Int J Impot Res 2007;19(2):213-217. 3. Mulhall JP, Creech SD, Boorjian SA et al. Subjective and objective analysis of the prevalence of Peyronie’s disease in a population of men presenting for prostate cancer screening. J Urol 2004;171(6 Pt 1):2350-2353. 4. 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