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8

What are the treatment options for Peyronie’s disease?

A urologist may treat Peyronie’s disease with

nonsurgical treatments or surgery.

The goal of treatment is to reduce pain and restore and

maintain the ability to have intercourse. Men with small

plaques, minimal penile curvature, no pain, and

satisfactory sexual function may not need treatment

until symptoms get worse. Peyronie’s disease may

resolve on its own without treatment.

A urologist may recommend changes in a man’s lifestyle

to reduce the risk of ED associated with Peyronie’s

disease.

Non-surgical treatments

Nonsurgical treatments include medications and

medical therapies.

Medications and remedies used “off label” . A Urologist

may prescribe medications aimed at decreasing a man’s

penile curvature, plaque size, and inflammation. A man

may take prescribed medications to treat Peyronie’s

disease orally––by mouth––or a urologist may inject

medications directly into the plaque.

VITAMIN E

this antioxidant has been widely used in the

treatment of Peyronie’s disease since 1948, though

scientific evidence on its effect is lacking.

POTABA

or potassium para aminobenzoate is related to

B complex vitamins and theoretically can help the supply

of oxygen to inflamed tissues.

COLCHICINE

is a medication used for many years in the

treatment of Gout. It acts against inflammation, and

interferes with collagen (scar) synthesis. There is weak

evidence for its effects against Peyronie’s in clinical trials.

It can cause diarrhea, and should not be used in patients

who are on statins (cholesterol-lowering drugs) due to

the risk of muscle inflammation.

TAMOXIFEN

is a non-steroid antiestrogen that may

inhibit scar-producing cells. Clinical evidence for use in

Peyronie’s disease is weak .

ACETYL CARNETINE

appears to reduce cellular damage

due to inflammation. Clinical trials in Peyronie’s patients

have shown minimal effects.

L-ARGENINE

is an amino acid supplement that is a

precursor to a nitric oxide, a neurotransmitter critical for

erection, and is thought to inhibit fibrosis or scarring

PENTOXYFILLINE

improves red blood cell circulation in

vascular disorders, and may help to locally reduce

scarring following inflammation.

Injections.

Medications injected directly into plaques may include

VERAPAMIL

blocks the delivery of scar tissue precursors

into an area of wound healing. Injection directly into the

plaques has shown varying degrees of success.

ALPHA INTERFERON

is a signaling protein that plays a

role in human immune responses, by inhibiting the

proliferation of cells. It was the first anti-Peyronie’s

disease drug to be tested in a multi-institutional clinical

trial, where comparison to placebo showed a small effect

on curvature reduction. It has a tendency to produce

systemic flu-like symptoms.

STEROIDS

especially in case of durable pain.

Collagenase (Xiaflex) with FDA approval(not available in

Europ)

Xiaflex is a proprietary combination of two enzymes

found in cell-free filtrates from cultures of the bacterium

Clostridium Histolyticum. This mix of powerful enzymes

is highly specific for collagen, the molecular constituent

of scar tissue. It is capable of dissolving this scar tissue at

normal body temperature and pH, reducing the curving

or distorting effect scar creates in the erectile bodies

(corpora cavernosa) of the penis. It has been FDA

approved for use in the hand (treating Dupuytren’s

contractures) since 2011, and in December 2013 for use

in Peyronie’s disease. Results are encouraging.

Local therapies.

A urologist may use medical therapies to break up scar

tissue and decrease plaque size and curvature.

Therapies to break up scar tissue may include

shockwave therapy

- focused, low-intensity

electroshock waves directed at the plaque

Iontophoresis

- painless, low-level electric current that

delivers medications through the skin over the

plaque to decrease plaque size and curvature.

mechanical traction and vacuum devices aimed at

stretching or bending the penis to reduce curvature.