臨床泌尿器科68巻2号

2014年02月発行

特集 男性性器疾患を診る―初期対応から専門的治療まで

ペロニー病：診断と治療

著者： 松下一仁¹

所属機関： ¹聖路加国際病院泌尿器科

ページ範囲：P.109 - P.114

要旨　ペロニー病は，繰り返される陰茎への微小な外傷後に創傷治癒の障害が影響して起こると考えられている。欧米人と比較して日本人の有病率は低いという報告もあるが，以前考えられていたほど患者は少なくない。男性は陰茎の疼痛，ED，陰茎長の短縮，あるいは陰茎の変形や彎曲などさまざまな兆候や症状で受診する。この病態は，患者とそのパートナーに肉体的そして精神的に荒廃的な影響をも及ぼす。期待できる有効な薬物治療，保存的治療は今までなかなか現れなかったのが現状である。手術療法は，安定期で陰茎の重度な彎曲や変形，治療抵抗性のEDがある場合にオプションとなるが，陰茎の短小化，亀頭部のしびれ，神経血管損傷，感染やEDのように深刻な合併症の可能性があるためにできるだけ深刻なケースのためにとっておかれる。2013年12月，米国のFDA（Food and Drug Administration）は，ペロニー病の薬としてcollagenase clostridium histolyticum（CCH）を承認した。このCCHのプラークへの局注は有意に陰茎の彎曲を改善させるという報告もあり，このFDAの承認はペロニー病にとってとても大きな出来事であった。

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