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591 In elderly patients, managing DPN alongside other chronic conditions becomes more complex due to polypharmacy, potential drug interactions, and physical and cognitive limitations

Two large RCTs, The Investigation for Maximal Peyronis Reduction Efficacy and Safety Studies (IMPRESS) I and II, examined the efficacy and safety of intralesional clostridial collagenase in the treatment of PD and obtained high-level evidence ( Although patients with penile curvature from 30 to 90 were included in IMPRESS I/II and the deformity were corrected for mean 17 in CCH-treated group, greater overall satisfaction of IIEF was also achieved in treatment group, indicating that the improvement in satisfaction is associated not only with reduced curvature but also objective elements

on the other hand, phytoestrogen may also have some prothrombotic or proinflammatory effects that may offset other benefits (Herrington, 2000)

We would like to thank the anonymous reviewers for their constructive and helpful comments, which have significantly improved the quality and clarity of our manuscript