Getting Treatment

Diagnosis

Peyronie's disease diagnosis is typically achieved with a physical exam and an ultrasound. The hardened tissue caused by the disorder can be felt upon examination, and calcified plaque can be identified using an ultrasound.

Preparing for your appointment is important. To make sure you bring the right information, Print and use this document as a guide for talking with your doctor

Peyronie's Disease Progression

If left untreated, roughly 40% of men with Peyronie's disease will experience a progression of the disease, 47% will experience no change and 13% will have disease regression over time.1

Phase 1: Acute Inflammatory Stage

The acute inflammatory stage can last from 6-18 months. Sufferers may experience pain; varying degrees of penile curvature, shortening or indentation; and the formation of a lump of scar tissue.

Phase 2: The Chronic Stage

In the chronic stage, a stable plaque forms and the deformity stabilizes, which may result in erectile dysfunction or loss of penile length. Many urologists prefer to wait at least one year to surgically correct the curvature, to help keep it from returning.

The progression of Peyronie's disease will vary from patient to patient.

Treatments for Peyronie's Disease

You should always consult a physician before beginning any treatment plan. Below are brief descriptions of current treatment options for you to review and discuss with your doctor. In many cases of Peyronie's disease, treatment may not be needed.

Nonsurgical methods of treatment are recommended. If the condition is severe enough, you may want to discuss a surgical option with your physician.

Oral Medications

Some doctors may prescribe vitamin E, Potaba® (potassium aminobenzoate), pentoxifylline, tamoxifen, carnitine, colchicine or L-arginine. Scientific studies have been conducted on some of these medications, but there is no conclusive evidence that they are effective.

Injections

Verapamil and interferon injections have produced measurable improvement for about half of the patients who have tried them, and some injections may help relieve associated pain. There is no evidence that steroid injections are helpful, and according to the WHO, they may be harmful.

Topical Treatments

Verapamil is also used as a topical treatment, but there is no evidence that any topical treatment improves the condition.

Shock Wave Therapy

In this therapy, a shock-wave, typically generated by a spark plug, is passed through the skin and directed at the plaque. Recent studies have not shown any benefit in treating curvature.

Energy Therapy

Energy (e.g., from ultrasound or lasers) is used to drive a drug into the scar tissue to help break up the plaque. Studies have not shown any benefit in the condition.

Traction Devices or Penis Stretchers/Extenders

These devices stretch the penis and scar tissue in an attempt to straighten it. Studies are underway to determine the effects of these devices.

Vacuum Therapy

A vacuum cylinder uses suction to reduce curvature. There are no data available for this type of therapy.


Other nonsurgical therapies are currently under investigation, and this site will be updated as data become available. In some cases your doctor may recommend watchful waiting before prescribing treatment.

Because Peyronie's disease develops over time, waiting 6 months to a year from the onset of the disease before pursuing corrective surgery is recommended. The goal of surgical therapy is to straighten the penis and restore function. There are two ways to straighten a curved penis, either by reducing the length of the outside of the curve or by increasing the length of the inside of the curve, as shown below.

Plication Procedure

In this procedure, the outside of the curvature is altered to straighten the penis. In 67% of patients, the penis loses some length as a result of this procedure, but patients still report a 79% to 85% satisfaction rate.1

peyronie's disease - before and after plication procedure

Plaque Incision or Excision and Grafting

This procedure removes tissue on the inside of the curve and replaces it with a graft to allow the penis to straighten. The graft may be tissue from the patient, a biologic graft material such as Cook Medical's Biodesign® Peyronie's Disease Repair Graft or a cadaveric pericardial graft.

peyronie's disease - before and after graft procedure

Prosthesis Implantation

In this procedure, for men who have Peyronie's disease and severe erectile dysfunction, an inflatable penile prosthesis is implanted.



The book Understanding Peyronie's Disease: A Treatment Guide for Curvature of the Penis by Laurence A. Levine, MD, is an additional source of patient-friendly information on Peyronie's disease and its treatment.2

References

  1. Tornehl CK, Carson CC. Peyronie's disease: individualizing the surgical approach. Contemp Urol. 2004;16(6).
  2. Levine LA. Understanding Peyronie's Disease: A Treatment Guide for Curvature of the Penis. Omaha, Nebraska: Addicus Books; 2007.

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