What Treatments Available for Peyronie’s Disease?

 In milder cases of Peyronie’s disease, you may not need to be treated surgically because the symptoms will go away without causing a permanent curve or pain.

Some men with severe cases of curve penis that interferes the ability to perform sexual intercourse, surgical treatment is often recommended by your urologist to remove the plaque in order to straighten the penis and to help return sexual function normally.

Just keep in mind that all surgical procedure, has its benefits, risks, and side effects.

If you need to be treated, there are many treatment options available that suits your case in both surgical and nonsurgical treatments:

Surgery

A urologist may recommend surgery to remove the plaque if the deformity of your penis is severe, painful erections and difficulty to have sexual intercourse. However, surgery is  not recommended until the symptoms of bent penis disappear.

Various surgical treatments may include:
  • Extracorporeal shock-wave therapy. This might be safest procedure that uses vibrations from sound waves to break down the scar tissues.
  • ‘Cold steel’ surgery method. This method  is using the conventional surgical instruments such as the following:

 a. Excision and Grafting. This procedure may help straighten the penis by removing the scar tissue (plaque) in the tunica albuginea, allowing the sheath to stretch out and restore some lost length from Peyronie’s diesease. (See picture on the left) However, this procedure is linked to greater risks of worsening erection problem compared with plication procedures.

b. Plication (Suturing). This involves folding a piece of the tunica albuginea rather than removing the plaque completely, which helps to straighten the penis. Plication is less likely to cause erectile problem (ED), but cannot restore the shrinkage of the penis from Peyronie’s disease.

c. Nesbit tuck. This surgical treatment involves removing some scar tissue from the side of the penis opposite the plaque of the tunica albuginea, which helps straightening but shortening the penis length.

d. Laser surgery. It involves with the use of carbon dioxide laser to break down the plaque.

e. Penile Implant. An inflatable penile device is inserted to replace the spongy tissue to increase the rigidity of the penis and straightening. This method is recommended if both suffered with Peyronie’s disease and erectile dysfunction.

Non Surgical Treatments

There are many non-surgical options available to treat Peyronie’s disease that involves wearable devices (penis extenders), supplements, penis exercises or stretching, and medical therapies.

  • Prescription Medications. Initially, your doctor may prescribe medication to treat Peyronie’s disease for a period of 12 to 18 months. But no oral treatments has been proven to work yet and need more study to see if they work. These drugs may include:
    • Potassium para-aminobenzoate (Potaba)
    • Colchicine
    • Propoleum
    • Tamoxifen
    • Pentoxifylline (Trental)
  • Non-Prescription Medications.  There are other oral treatments or food supplements that have been used to treat Peyronie’s disease, though further study on their efficacy is limited. They are:
    • Vitamin E
    • Acetyl-L carnitine
    • Omega-3 fatty acids
    • Co-enzyme Q10
  • Injections. Injection is an option for men who does not want the risk for surgery. Medications injected directly into plaques may include:
    • Injections that have shown positive results for Peyronie’s diease are:
      • Collagenase (Xiaflex®) – the first and only medication approved by FDA for the treatment of  Peyronie’s disease with an upward bent more than 30 degrees
      • Verapamil – used to treat with high blood pressure, but studies have shown a positive result for penile pain and Peyronie’s disease
      • Interferon alpha 2b – help to slow down the plaque and help control the scarring
    • Penile injections for Peyronie’s disease that needs further more study if they work include:
      • Liposomal recombinant human superoxide dismutase (LrhSOD)
      • Nicardipine
      • Parathyroid hormone
      • Dexamethasone
      • Betamethasone with hyaluronidase and lidocaine
      • Iloprost
      • Verapamil in combination with dexamethasone or with lidocaine electromotive
  • Medical therapies. This involves with the use of  weak electrical current to help break down the scar tissue and decrease plaque size and degree of curvature. But this treatment is no longer considered effective. They are:
    • Shockwave therapy
    • High-intensity ultrasound 
    • Radiation therapy
  • Traction Devices (Penis Extenders). A wearable device that helps straighten and stretches the penis for 2-6 hours a day. Men who have tried penis extenders have shown positive results in terms of curvature correction and at the same time it lengthens the penis. This is non-surgical and non-expensive Peyronie’s disease natural treatment.