Peyronie's Disease as a marker of inflammation -is there hope on the horizon?

While the description of Peyronie's disease, a connective tissue disorder involving the growth of fibrous plaques in the soft tissue of the penis, is attributed to Francois de la Peyronie, Surgeon to Louis XV of France, there are earlier reports. Over the intervening 450 years, a variety of empiric treatments, varying in barbarity, have been proposed. The frequency of this condition and the etiology of the fibrosis are unknown. Quality of life for affected men, and their partners, is adversely impacted. In this review, the authors summarize the history of the discovery of this condition, review contemporary management approaches, and address the pathophysiology leading to the underlying disordered fibrosis. The potential immunomodulatory role of testosterone, as well as inflammatory conditions and environmental stimuli that may provoke fibrosis are also considered. Peyronie's disease may be part of a spectrum of fibrotic conditions, including Dupuytren's contracture. Treatment strategies to date have focused on reversing fibrosis; work is needed to prevent fibrosis and to accurately document disease prevalence.