Treatment with stromal vascular fraction of Peyronie's disease - a study protocol

INTRODUCTION

Peyronie´s disease is the result of an acquired fibrotic plaque in the tunica albuginea. It remains unknown why the condition appears, but it seems to affect up to 9% of all men. It can result in a debilitating curvature of the erect penis, which has extensive impact on the quality of life for many men. Thus, the disease may result in low self-esteem, depression and impaired sexual performance.

METHODS

This is a prospective pilot study investigating the feasibility and safety of stromal vascular fraction injection into the plaque of 22 men with Peyronie´s disease in the chronic phase. The stromal vascular fraction is obtained from a small liposuction of 250 ml fat in general anaesthesia and injected the same day.

CONCLUSION

We hope to show that injection of stromal vascular fraction is safe and effective in reducing curvature in men with Peyronie´s disease.

FUNDING

The study was made possible with funding from: the Region of Southern Denmark, Louis-Hansen Fund, Lizzi and Mogens Staal Fund, Karola Jørgensen Fund, Marie and Børge Kroghs Fund, the Senior Doctors Research Fund OUH, the Fund for gentle Surgery OUH and the PhD fund of the executive board of the South West Denmark Hospital. The funding sources had no influence on the trial design, data collection, analysis or publication.

TRIAL REGISTRATION

CLINICALTRIALS

gov NCT04771442, EudraCT 2020-004297-22, Danish Medicines Agency 2020090057, National Ethics Committee 74705 and Danish Data Protection Agency (record no. 1/21757).

Peyronie’s disease questionnaire: translation into Danish and cultural adaptation

Background

Peyronie’s disease has an impact on men’s mental and physical health.

Aim

We sought to translate the Peyronie’s Disease Questionnaire into Danish, adapt it to the Danish cultural setting, and test it in a Danish population.

Methods

Translation of the Peyronie’s Disease Questionnaire was performed according to the guidelines for adapting health status measures for use in languages other than the source language by Beaton et al. The validated American Peyronie’s Disease Questionnaire was developed to monitor patient symptoms after an intervention and to inspire a subsequent dialogue about physical and psychological symptoms with a healthcare provider, thereby allowing the patient and the healthcare professional to choose the best treatment. The expert committee agreed on a Danish version after cross-cultural adaptation. The Danish Peyronie’s Disease Questionnaire was sent by electronic mail to a preselected group of 41 men with Peyronie’s disease.

Outcomes

After completing the questionnaire, 32 men participated in a video interview regarding the questionnaire and were asked to identify any problematic fields or areas open to misunderstanding.

Results

The Peyronie’s Disease Questionnaire underwent major modifications in light of the comments of the first 10 respondents. Thereafter, only minor changes were made until data saturation was reached after 27 of the 32 respondents had been interviewed. In 87% of respondents Peyronie’s disease bothered from the last time they had intercourse, and 93% of the men experienced being bothered by having intercourse less often. Peyronie’s disease made 73% of respondents feel bodily discomfort, and 88% had intercourse less often than they used to have due to Peyronie’s disease.

Clinical Implications

The Peyronie’s Disease Questionnaire is a valuable tool in the crucial task of addressing Peyronie’s disease, providing insight into the mental and sexual health problems as well as physical challenges faced by patients.

Strengths and Limitations

The interviewer’s modest experience in conducting interviews is believed to have been duly compensated for by continuous and accumulating learning-while-doing process because the same interviewer conducted all of the interviews and did so consecutively.

Conclusions

Danish men expressed satisfaction with the questionnaire and found it valuable as a tool when visiting the doctor for the first time.

[The effect of primary colonoscopy versus follow-up colonoscopy in screening for colorectal cancer]

Balancing indications for primary and follow-up colonoscopy in screening is important. In the lowest faecal test positive range of 100-150 ng/ml the rate of cancer is 1.9%, and the rate of intermediate and high-risk adenomas is 16.7%. International studies suggest, that only selected groups have comparable rates of significant findings at follow-up, and the risk normalises after one colonoscopy. In this review it is found, that in the current Danish screening programme for colon cancer the indications of primary screening and follow-up colonoscopy seem to be off-balance, but no national data exist on follow-up.