RUDN Journal of MedicineRUDN Journal of MedicineВестник Российского университета дружбы народов. Серия: Медицина2313-02452313-0261Peoples’ Friendship University of Russia named after Patrice Lumumba (RUDN University)2339110.22363/2313-0245-2020-24-1-9-25SURGERY. UROLOGYХИРУРГИЯ. УРОЛОГИЯReview ArticleCurrent issues of pathogenesis, diagnostic visualization and methods of treatment Peyronie’s diseaseАктуальные вопросы патогенеза, диагностической визуализации и методов лечения болезни ПейрониKasenovaB. G.КасеноваБ. Ж.verdievrafik@gmail.comNotovI. K.НотовИ. К.verdievrafik@gmail.comVerdievR. V.ВердиевР. В.verdievrafik@gmail.comVolobuevD. I.ВолобуевД. И.verdievrafik@gmail.comAlievU. M.АлиевУ. М.verdievrafik@gmail.comMikailovaS. E.МикаиловаС. Э.verdievrafik@gmail.comErkovichA. A.ЕрковичА. А.verdievrafik@gmail.comTulupovA. A.ТулуповА. А.verdievrafik@gmail.comSatinovA. V.СатиновА. В.verdievrafik@gmail.comUrological department of Khanty-mansiysk Autonomous Region-Ugra Nizhnevartovsk clinical hospitalУрологическое отделение Нижневартовской окружной клинической больницыNovosibirsk State Medical UniversityНовосибирский государственный медицинский университетPirogov Medical UniversityРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаThe International Tomography Center of the Siberian Branch of the Russian Academy of the SciencesЦентр «МРТ Технологии» Международного томографического центра Сибирского отделения РАНBurnazyan Federal Medical Biophysical CenterФедеральный медицинский биофизический центр имени А.И. Бурназяна15122020241VOL 24, NO1 (2020)ТОМ 24, №1 (2020)92508042020Copyright ©; 2020, Kasenova B.G., Notov I.K., Verdiev R.V., Volobuev D.I., Aliev U.M., Mikailova S.E., Erkovich A.A., Tulupov A.A., Satinov A.V.Copyright ©; 2020, Касенова Б.Ж., Нотов И.К., Вердиев Р.В., Волобуев Д.И., Алиев У.М., Микаилова С.Э., Еркович А.А., Тулупов А.А., Сатинов А.В.2020Kasenova B.G., Notov I.K., Verdiev R.V., Volobuev D.I., Aliev U.M., Mikailova S.E., Erkovich A.A., Tulupov A.A., Satinov A.V.Касенова Б.Ж., Нотов И.К., Вердиев Р.В., Волобуев Д.И., Алиев У.М., Микаилова С.Э., Еркович А.А., Тулупов А.А., Сатинов А.В.http://creativecommons.org/licenses/by/4.0https://journals.rudn.ru/medicine/article/view/23391

This paper presents current survey data on the epidemiology, etiopathogenesis, diagnostic imaging, conservative and surgical methods of the treatment for Peyronie’s disease. The review of literature ends with a conclusion that there is no single point of view on causes and mechanisms of this disease. Particular theories of etiopathogenesis were observed: anatomical, autoimmune, genetic, oxidative stress theories and TGF-β impact role. Early diagnosis is necessary to achieve optimal effects of the treatment. Sonography with or without cavernosography are recommended as routine diagnostic visualization methods. Magnetic resonance imaging also could be used according to the indications. Morphometric penile evaluation could be performed with different modern methods; quantitative assessment has a particular role. In addition, comparative characteristics of diagnostic imaging methods were described. Among nonsurgical therapeutic methods, we spotted peroral, injection and shock wave therapy. Peroral therapy does not impact plaque size and penile curvature and should be used only in active phase to stabilize the process. Shock wave therapy does not affect plaque size as well, but has a positive effect on pain syndrome and erectile function. Injection therapy with collagenase clostridium histolyticum is the most effective method among nonsurgical ones. Main surgical techniques such as plication, grafting, penile prosthesis placement and also rehabilitation in postoperative period were observed in this review. Surgery maintains to be golden standard in Peyronie’s disease and is performed in patients with stable phase, as well as in patients with severe deformity and with drug-refractory condition.

В работе представлены актуальные обзорные данные по эпидемиологии, этиопатогенезу, диагностической визуализации, нехирургическим и хирургическим методам лечения болезни Пейрони (БП). На основании изученной литературы можно сделать выводы об отсутствии единой концепции причин и механизмов возникновения данного заболевания. Рассмотрены отдельные теории этиопатогенеза: анатомическая, аутоиммунная, генная, теория оксидативного стресса, а также роль TGF-β. Для достижения оптимальных результатов лечения необходима ранняя и своевременная диагностика, для чего рекомендуется рутинное проведение всем больным с БП ультразвукового исследования, а также выполнение магнитно-резонансной томографии больным по показаниям; особую роль играют средства количественной оценки деформации. В статье представлена сравнительная характеристика методов диагностической визуализации при БП. Среди нехирургических методов рассмотрены пероральная, инъекционная и ударно-волновая терапия. Пероральная терапия не влияет на размер бляшки и степень искривления полового члена, применяется только в активной фазе заболевания и имеет цель стабилизировать процесс. Ударно-волновая терапия также не влияет на размер бляшки, однако оказывает положительный эффект в отношении выраженности болевого синдрома и эректильной функции. Наибольшей эффективностью отличается инъекционная терапия клостридиальной коллагеназой. В обзоре описаны основные хирургические методики лечения БП: пликационная, графтинг техника с видами трансплантатов и фаллоэндопротезирование; также освещены вопросы реабилитации в послеоперационном периоде. Хирургическое лечение остается золотым стандартом при БП и проводится больным в стабильной фазе, с выраженной деформацией и с рефрактерностью к медикаментозному лечению.

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