Cavernosopatía traumática crónica. Un nuevo síndrome de fibrosis peneana

Introduction The condition called "Peyronie's disease" is a diagnosis that explains a percentage of the states of severe penile fibrosis, but not enough to cover the wide grey range of penile fibrosis secondary to repeated sexual micro-trauma. Purpose To describe a new syndrome due to repeated trauma to the penis, which is proposed to be called "Chronic traumatic cavernopathy" (CTC), with 4 components: fibrosis, erectile dysfunction, curvature and penile venous leakage. Materials and Methods A cross-sectional study was conducted on a database of 128 patients who had at least one penis ultrasound performed with a vasoactive, and had some degree of cavernous fibrosis according to Levine classification. An evaluation was made on the presence of erectile dysfunction, curvature, and venous leakage depending on the degree of fibrosis. The study was approved by the Research Ethics Committee. Results The study included 128 patients with penile fibrosis, and a mean age of 52.9 years (SD = 13). The degree of fibrosis was mild (Levine 1) in 30 (23.43%), moderate (Levine 2) in 23 (17.96%), and severe (Levine 3) in 75 (58.6%). It was shown that the higher the fibrosis, the more erectile dysfunction (ED), with 66.6%, 83.6%, and 96% for Levine 1, 2, and 3 respectively (P 0.0001). Frequency of secondary curvature (n = 71) was 0%, 4.2%, and 95.7% for Levine 1, 2, and 3, respectively (P 0.0001). The frequency in 44 cavernous patients with venous leakages was 9%, 20.4%, and 70.4% (P = 0.0060), and with 15 dorsal leakages it was 80%, 13.3%, and 6.6% (P < 0.0001) for Levine 1, 2, and 3, respectively. The group of 79 (64.03%) patients with increased possibility of CTC, and who met the 4 criteria, or the 3 criteria including secondary curvature and cavernous venous leakage, had a mean age of 59.2 years (SD = 8.7), compared to 41.7 years (SD = 11.7) in the other group with less possibility, which had a statistically significant difference (P 0.0001). Conclusions We propose that there is a syndrome of repeated micro-trauma in penis, which can be called CTC, analogous to chronic traumatic encephalopathy, with 4 components: cavernous fibrosis, erectile dysfunction, penile curvature, and venous leak. Fibrosis is a continuum that, in the patient goes through mild and moderate stages, and often goes unnoticed by clinicians. Secondary curvatures and cavernous leaks are directly related to the degree of fibrosis and increased risk of erectile dysfunction. Age aggravates some factors of CTC.