Modern possibilities of diagnosis and treatment of Peyronie's disease in the Czech context.

Peyronie's disease is an acquired fibrotic disorder of the tunica albuginea, leading to penile deformity, painful erections, and often erectile dysfunction; its prevalence in Europe reaches up to 9% in middle-aged men. This review summarizes the results of studies from 2019-2025 concerning diagnostic methods and therapeutic options. Based on the analysis of 142 original studies, 23 meta-analyses, and current European Association of Urology (EAU) a American Urological Association (AUA) recommendations, we confirm that intralesional verapamil reduces curvature in the active phase by an average of 9-17° and low-intensity shockwave therapy (LiSWT) improves pain and reduces curvature by approximately 10°, particularly for plaques larger than 2 cm. Surgical methods - plication, incision/grafting, and penile prosthesis implantation - achieve initial straightening in more than 90% of cases but differ in impact on penile length and the risk of de novo erectile dysfunction. Regenerative therapies like platelet-rich plasma (PRP) or mesenchymal stem cells (MSC) offer promising, yet currently experimental results. Optimal care is based on early diagnosis, individualization of conservative treatment, and precise surgical correction; in the Czech Republic, standard approaches include verapamil, LiSWT, and surgery, while biological approaches require further research.