Ryan P. Terlecki, MD, FACS, presented “Conquering the Curve in Peyronie’s Disease” at the 11th Urology Today conference on October 27, 2023.
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How to cite: Terlecki, Ryan P. “Conquering the Curve in Peyronie’s Disease.” October 2023. Accessed Nov 2024. https://grandroundsinurology.com/conquering-the-curve-in-peyronies-disease/
Conquering the Curve in Peyronie’s Disease – Summary
Ryan P. Terlecki, MD, FACS, discusses risks and benefits of Peyronie’s disease treatments, advocating for surgery as a definitive treatment. Dr. Terlecki asserts the condition is poorly understood with a “lot of garbage” in print and online. (e.g., advice not to operate early on, assumptions the injury is from tunical damage, and problematic data on intralesional injections).
From a treatment standpoint, Dr. Terlecki addresses treatment dogma he sees as problematic. He debunks claims for various treatments, like vitamin E, colchicine, Xiaflex, and pentoxifylline, and makes a case against extracorporeal shock wave therapy.
Dr. Terlecki addresses surgery and explains that, for patients with adequate rigidity, plication or grafting is effective. However, patients with inadequate function require inflatable penile prosthesis (IPP) and curvature correction. He cautions against degloving, tunical excision, and plicating for implant cases.
Dr. Terlecki concludes that Peyronie’s patients are often distressed and need clear communication and a realistic understanding of treatment risks and benefits. He calls surgery the gold standard, and says plication should be considered first for potent patients without complex defects.
About The 11th Urology Today Conference:
Presented by chair Ryan P. Terlecki, MD, FACS, the 11th Urology Today conference was designed to keep urologists, urologic oncologists, and other healthcare providers educated on the most pertinent issues in urology practices. Areas of focus included urologic oncology, men’s health and reconstruction, female urology, pediatric urology, kidney stones and related conditions, and methods of providing the best care amidst the required logistics of the business side of medicine.
For further educational activities from this conference, visit our collection page.
ABOUT THE AUTHOR
Ryan P. Terlecki, MD, FACS, is a reconstructive urologist for Atrium Health Wake Forest Baptist Medical Center, an academic Level 1 trauma center in Winston-Salem, North Carolina. Dr. Terlecki holds the rank of Professor and the title of Vice Chair of Research for the Department of Urology. In addition, Dr. Terlecki is Director of the Men’s Health Clinic, Director of Medical Student Education, and Fellowship Director for Reconstructive Urology. He holds a joint appointment in the Department of Obstetrics and Gynecology.
Dr. Terlecki earned his medical degree from Wayne State University School of Medicine and completed residency in general surgery and urology at Detroit Medical Center. Following his residency, Dr. Terlecki completed two separate fellowships in reconstructive surgery. He completed a fellowship at the University of Colorado’s Denver School of Medicine and at UT Southwestern Medical Center in Dallas, Texas.
Dr. Terlecki’s publications cover multiple areas of trauma and reconstruction and his research is focused primarily on models of wound healing and regeneration in the lower genitourinary system. Dr. Terlecki’s areas of expertise include urethral stricture disease, male sexual dysfunction, male incontinence, Peyronie’s disease, chronic testicular pain, hypogonadism, and infertility. He is a member of the Society of Genitourinary Reconstructive Surgeons (GURS), a member of the American Urological Association (AUA), and past president of the North Carolina Urological Association (NCUA).
