مرض بيروني في المرحلة النشطة عندما لم يُحقق العلاج المحافظ الأولي حل الألم عند الانتصاب أو استقرار انحناء القضيب

References

1. Patients who are still likely to have active disease are those with a shorter symptom duration, pain on erection, or a recent change in penile deformity.
2. Conservative treatment of PD is primarily focused on patients in the early stage of the disease as an adjunct treatment to relieve pain and prevent disease progression, or if the patient declines other treatment options during the active phase.
3. The original treatment protocol in all studies consists of two injections of 0.58 mg of CCH 24–72 hours apart every six weeks for up to four cycles.
4. A modified short protocol consisting of administration of a single (0.9 mg, one vial) injection per cycle distributed along three lines around the point of maximum curvature up to three cycles, separated by four-weekly intervals, has been proposed and rapidly popularised replacing physician modelling with a multi-modal approach through penile stretching, modelling and VED at home.
5. Use intralesional hyaluronic acid either alone or in combination with other treatments to reduce pain and/or penile curvature in acute phase PD, although outcome data are still limited.
6. Offer penile traction devices and vacuum devices to reduce penile deformity or as part of a multimodal therapy approach, although outcome data is limited.
7. Intralesional treatment with collagenase clostridium histolyticum showed significant decreases in penile curvature, plaque diameter and plaque length in men with acute and stable disease.