Tratamiento de  colagenasa en la enfermedad de la Peyronie, una solución más allá de la cirugía.


Hace 2 semanas, impartimos un curso para urólogos de toda España sobre el tratamiento con colagenasa en la enfermedad de La Peyronie. Me acompañaron como ponentes el Dr. Martínez Salamanca, uno de los mayores expertos en el tratamiento de esta patología, y el Dr. Eugenio Cerezo, probablemente el mayor experto nacional en ecografía de pene.

La colagenasa es una sustancia que permite romper o disminuir la placa localizada en la túnica albugínea del pene (una de las capas que envuelve los cuerpos cavernosos), causante de la curvatura del mismo en erección. El origen de esta enfermedad es desconocido, aunque la teoría más aceptada es que se debe a microtraumatismos en el pene durante la relación sexual en pacientes con una susceptibilidad genética. La consecuencia directa de esta enfermedad es la aparición de una curvatura en el pene durante la erección, dificultando en muchas ocasiones la penetración. En muchos casos, se acompaña de disfunción eréctil, acortamiento del pene y una repercusión psicológica significativa. Afecta mayoritariamente a hombres mayores de 45 años pero tratamos cada vez más a pacientes menores de 40 años.

La mayoría de los tratamientos médicos eran ineficaces y hasta ahora, la cirugía era la única opción válida de tratamiento. La colagenasa fue aprobada en el año 2013 para el tratamiento de esta enfermedad; antes lo había sido para la enfermedad de Dupuytren, que provoca una retracción de los dedos anular y meñique de la mano.

Este producto se administra mediante una inyección dentro de la placa. Un ciclo consta de 2 inyecciones, separadas por pocos días, y luego se realiza un modelling del pene que consiste en intentar “romper” la placa, seguidos de una serie de ejercicios que deberá realizar el paciente durante 12 semanas. Este tratamiento es el único aprobado por las agencias de salud para el tratamiento médico de esta enfermedad.

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