Peyronie’s disease - Care & cure

A review of various treatment options

History & background of Peyronie’s disease

Peyronie’s disease accounts for 0.3 to 0.7% of all urinary system related disorders and it occurs most often in the fourth to sixth decades of life, and occasionally in men less than 20 year old. A small number of men with Peyronie’s disease will get better without treatment but drug therapy or radiation are normally used. Most of the medical and surgical treatments, however, are designed to improve the symptoms of the disease rather than to cure it. The following article is a short review of all the major treatment options that are currently being used to treat or cure Peyronie’s disease.

Medical drug treatment

Medical drug treatment of Peyronie’s disease can be of two types:

Oral therapy: Oral medication therapy is only effective in the early, or the acute phase of Peyronie’s. Thus, within the first year of developing a plaque, drugs like PABA, vitamin E and colchicine are considered as effective first line treatments.  However, after one year with a plaque, oral medications are rarely helpful. 

Injection therapy: If the condition is not improved by oral drug treatment, doctors may prescribe intralesional injections with Verapamil, interferons or steroids.  The penis is anesthetized initially and then the medication is injected into several sites within the Peyronie’s Plaque.  Following a series of 6 injections spaced at least every other week, 2/3 of men have improvement in their curvature, and 80% have improved erections. Verapamil and interferon alpha-2b seem to diminish curvature of the penis. On the other hands, these drugs are not free of some serious side effects.  Steroids, such as cortisone, have frequently produced unwanted side effects, such as the atrophy or death of healthy tissues.

Surgery: If injections fail, surgical removal of the plaque and reconstruction can be performed.  While surgery is successful at correcting the curvature of penis, it rarely improves the erectile dysfunction and is also risky (because of high risk of associated complications) and costly (very expensive).

Extracorporeal Shock Wave Therapy

Extracorporeal shockwave therapy (ESWT) uses vibrations caused by sound waves to treat the affected tissue. The sound waves come from a device applied to the outside of the body that generates short bursts of sound, called ‘sonic pulses’. The plaques on the penis are targeted, normally using ultrasound as a guide. 

Radiotherapy

Radiation therapy, in which high-energy rays are aimed at the plaque, has also been used. Like some of the chemical treatments, radiation appears to reduce pain, but it has no effect on the plaque itself and can cause unwelcome side effects such as erectile dysfunction.

The key question in the treatment of Peyronie’s disease probably is can we prevent disease progression resulting in penile shortening and curvature without surgery? None of the currently available treatment modalities so far has so demonstrated this effect conclusively. Use of traction based extenders or penis stretchers (e.g. SizeGenetics), however, does offer an attractive, economical, safe and natural option that has been found to have a role in correcting and preventing the abnormal curvature of the penis in many men.