Diseases

Peyronie's Disease (Curvature of the Penis) Information

Medications, Vitamins, and Supplements

In December, 2013, the FDA approved collagenase clostridium histolyticum (Xiaflex) to treat individuals with Peyronie's disease. Each treatment cycle consists of two Xiaflex injections into the plaque in the penis to break up the collagen that causes the curvature deformity. Treatments consist of a maximum four injections.Oral therapy with vitamin E, colchicine, PABA, tamoxifen, and other medications have been tried with limited success in some patients. Usually those in the acute phase of the disease responded best.In the early stages of the disease, erectile dysfunction (ED) may be treated with such drugs as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis, Adcirca).Injection therapy using combinations of drugs mentioned above and adding prostaglandin E1 or other drugs such as betamethasone alone or with hyaluronidase; PABA has been reported to reduce the penile plaque size.Other drugs have also been used with varying degree of success. Verapamil (Calan, Verelan, Verelan PM, Isoptin, Isoptin SR, Covera-HS [a medication usually used for high blood pressure treatment]) appears to disrupt the production of a protein involved in the formation of Peyronie's disease leisons.Another method is iontophoresis (also termed electromotive administration or EMDA) where verapamil and other drugs are applied to the penile skin and pushed through the skin with a low electrical current.

Other therapies

Some individuals suggest stretching and/or milking the penis are exercises that can help reduce the penile curvature that occurs in the disease. Patients should discuss these techniques with their doctor (Urologist) before using these methods.

Peyronie's disease facts

• Peyronie's disease is the development of scar tissue inside the penis that results in abnormal curvature of the penis.
• The exact cause of Peyronie's disease is not known; however, research has suggested these agents as possible causes of plaque or scar formation in the penile shaft.
  • Vitamin E deficiency
  • Beta-blocking drugs
  • Elevation in serotonin levels
  • Genetic causes
  • Trauma to the penis
• Some of the symptoms of Peyronie's disease include:
  • Pain during erections and/or during sex
  • Erectile dysfunction
  • Anxiety or stress
  • The inability to have intercourse
• Peyronie's disease is diagnosed by physical examination of the penis that shows abnormal curvature and plaque/scar formation that may be palpated.
• There is no cure for Peyronie's disease; however, symptoms can be treated with vitamins, supplements, and other medications.
• Complications of the disease include pain with intercourse, inability to have intercourse, erectile dysfunction, depression and a permanent abnormal angulation of the penis
• The prognosis of Peyronie's disease varies from good to poor, depending on the individual's response to treatments

Shockwave therapy

Shockwave therapy (done with a lithotripter device like those used to break up kidney stones) has been used on plaque or scaring that is calcified. Other mechanical devices, including vacuum-based machines and low-dose radiotherapy have been tried. Although some successes are seen with these methods, best results are in acute phase patients. There are ongoing studies with different drugs (for example, interferons, and collagenase) and surgical techniques.

Surgery

Surgical therapy is done on some patients. These surgical patients usually have to meet criteria that may vary from surgeon to surgeon. In general, surgical therapy is done when other methods have failed or the patient is in the chronic stage of the disease and erectile dysfunction is part of the patient's symptoms. Surgical therapy may involve incision or cutting the scarred tissue, scar tissue removal, scar tissue removal with auto-grafting or artificial graft material. In addition, implanted devices (penile implant) that allow the patient to sustain an erection are also utilized in some individuals.