Induratio penis plastica: Herausforderungen der somatischen Therapie und Unterstützungsmöglichkeiten durch Psychotherapie

Zusammenfassung

Einleitung Die Induratio penis plastica (IPP) ist eine erworbene chronische Erkrankung der Tunica albuginea und/oder des Septums der Corpora cavernosa, die zu Deformitäten und Verkrümmungen des Penis führen und die Sexualität der Betroffenen stark beeinträchtigen kann. Darüber hinaus kann die IPP bei den betroffenen Patienten zu emotionalen Problemen und zu Beziehungsproblemen führen.

Forschungsziele Die vorliegende Übersichtsarbeit gibt einen Überblick über die konservativen und chirurgischen Therapieoptionen der IPP, geht detailliert auf die psychischen Besonderheiten und Probleme der Betroffenen ein und stellt mögliche psycho- und sexualtherapeutische Interventionen dar.

Methoden Es handelt sich um eine nicht-systematische narrative Übersichtsarbeit. Mithilfe einer Pubmed-Datenbankanalyse wurden Original- und Übersichtsarbeiten zur IPP identifiziert und im Hinblick auf Methodik und Ergebnisse ausgewertet. Überlegungen zur interdisziplinären Integration einer unterstützenden Psychotherapie werden angestellt.

Ergebnisse Die konservative und die chirurgische Therapie stellen keine kausale, sondern eine symptomatische Behandlung dar. Die Effektivität der konservativen Therapie ist eingeschränkt. Die chirurgische Therapie stellt den Goldstandard zur Behandlung der schweren IPP dar, kann aber Nebenwirkungen wie erektile Dysfunktion und Längenverlust des Penis zur Folge haben. Die IPP führt häufig zu psychischen Belastungen, die im Rahmen einer interdisziplinär integrierten Psychotherapie adressiert werden sollten. Ein entsprechend kombiniertes Vorgehen wird vorgeschlagen.

Schlussfolgerung Um die Erwartungen an die konservative und chirurgische Therapie nicht zu überhöhen, müssen die Patienten über die Möglichkeiten und Limitationen realistisch und ausführlich aufgeklärt werden. Die psychischen Spezifika und Belastungen sollten bei der Therapie der IPP interdisziplinär integriert berücksichtigt werden.

Abstract

Introduction Peyronie’s disease (PD) is a chronic connective tissue disorder of the tunica albuginea and/or septum of the corpora cavernosa of the penis, and may cause penile length loss as well as deformity and curvature of the penis. Thus, PD patients may suffer from severe impairment of sexual activity. In addition, PD patients may have emotional stress and relationship problems.

Objectives Our aim was to review the efficacy and limitations of non-surgical and surgical therapy of PD, to evaluate in detail psychological and relationship problems in PD patients, and to discuss feasible psychological interventions, and the potential role of sexual therapy and psychotherapy in PD patients.

Methods We performed a non-systematic Pubmed literature search to identify and to evaluate original and review articles regarding PD.

Results Neither non-surgical nor surgical therapies represent causative treatment, but are rather treatment options for symptoms. The efficacy of non-surgical therapies is limited. Surgical therapy represents the gold standard treatment in patients with severe PD, but possible complications include erectile dysfunction and loss of penile length. PD may cause psychological distress and relationship problems. In addition, PD patients may suffer from depression and anxiety.

Conclusion Thorough patient counseling regarding efficacy and limitations of non-surgical and surgical therapies is necessary in order to set realistic patient expectations. It is also important to consider psychological problems when treating patients with PD.

Schlüsselwörter

Depression - erektile Dysfunktion - Induratio penis plastica - Morbus Peyronie - Sexualtherapie

Key words

depression - erectile dysfunction - Peyronie’s disease - sexual therapy

Fußnoten

^* Beide Autoren haben gleichermaßen zu dieser Arbeit beigetragen.

Publication History

Article published online:
07 December 2021

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