A combination of phosphodiesterase type 5 inhibitor and tamoxifen for acute Peyronie’s disease: the first clinical signals

Peyronie’s disease (PD) is a fibrotic disorder of the penile tunica albuginea (TA) and can lead to pain during erection and/or intercourse, penile curvature, erectile dysfunction, and penile deformity and/or shortening, with psychosocial consequences and impact on patients and their partners. PD has been reported to affect 0.3% to 13.1% of men in the general population, and the prevalence has been reported to increase with age, diabetes, hypertension, hyperlipidemia, Dupuytren’s contracture, smoking, alcohol consumption, postradical prostatectomy, and erectile dysfunction.¹

While the exact pathophysiology of PD remains unclear, it is believed that microvascular trauma, or repetitive minor trauma, leads to inflammation in TA, which triggers the release of profibrotic cytokines such as transforming growth factor β1. Increased concentrations of transforming growth factor β1 for prolonged periods due to unresolved wound healing ultimately leads to transformation of resident fibroblasts to profibrotic myofibroblasts. Myofibroblasts are responsible for excessive production and deposition of extracellular matrix proteins such as collagen, which is then remodeled into a dense fibrotic plaque that may cause the onset of penile curvature and the related signs and symptoms of PD