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Treating Peyronie’s Disease Without Surgery

Jan 02, 2017

Treating Peyronie’s Disease Without Surgery

Kevin was nervous about his upcoming appointment with his urologist. He had been having painful erections for a while now, and he didn’t like to admit there could be a problem with his private parts. But he knew he had to do something. Now, in addition to pain, he was having trouble with sex. His penis curved about 30 degrees when erect and vaginal sex with his girlfriend Lily was getting difficult. Sometimes it even hurt for her.

Lily was understanding and had been encouraging him to see a doctor. They had been reading up on Peyronie’s disease, a condition that causes plaques to form just under the skin of the penis. The plaques made the penis less flexible, and that’s why the curve was happening. They also read that Peyronie’s disease could be a wound healing disorder. Kevin had no idea how he might have injured his penis, but Lily pointed out that they liked vigorous sex. Maybe they’d been a little too vigorous.

Kevin didn’t want to admit it to Lily, but he was worried about needing surgery. He would do it if it meant he could get his sex life back, but he was hoping there would be another option.

Fortunately, there are other avenues. For some men, Peyronie’s disease can be treated nonsurgically. Recently, the American Urological Association issued new clinical guidelines on these approaches. With these guidelines in mind, a team of experts reviewed medical studies on the topic. Let’s take a closer look.

Oral Therapies

Oral therapies – pills that can be taken by mouth – include vitamin E, Tamoxifen,

potassium para-aminobenzoate, and phosphodiesterase type 5 inhibitors. (The latter are the same medications used to treat erectile dysfunction, such as Viagra, Cialis, and Levitra.) The experts noted that oral drugs are not used often to treat Peyronie’s disease, as their effectiveness is limited. Also, some patients experience side effects, like stomach upset, that may make them stop treatment altogether.

Intralesional Therapies

Intralesional treatments are injected directly into the plaques in the penis. While the idea of injections might make men squeamish, they can be quite effective. Currently, the U.S. Food and Drug Administration has approved only one drug for the treatment of Peyronie’s disease – Xiaflex - which is administered this way. Other intralesional therapies are being investigated, however.

Traction Therapy

Men who undergo traction therapy wear a special device that gently pulls the penis in the opposite direction of the curve. Usually, the device is worn for several hours each day. The authors wrote that this therapy has an “overall minimal impact” on its own, but it could work well in conjunction with other treatments (such as intralesional therapies), especially if men are worried about shortening of the penis.

Topical Therapies

A topical medication is one that can be applied directly to the skin. Different topical treatments for Peyronie’s disease have been studied, but the authors concluded that “no topical therapy currently appears to be effective for [Peyronie’s disease].” One topical combination they reviewed did have good results, but the study was designed to assess safety, not effectiveness. More research is needed.

Extracorporeal Shock Wave Treatment

With this approach, shock waves are administered to the penis using a special device outside the body. The authors explained that this therapy could help men with pain, but not with curvature. They added that pain from Peyronie’s disease often gets better on its own, in time.

Which Treatment Should a Man Choose?

The answer to this question depends on his situation. A urologist will assess the stage of Peyronie’s disease, the type and degree of curvature, and experiences with pain and/or erectile dysfunction. After a thorough exam, a man and his doctor can discuss the treatment options best suited for him.

Resources

SexHealthMatters.org

“Peyronie’s Treatments – Traction Therapy and VEDs”

(July 10, 2014)

http://www.sexhealthmatters.org/sex-health-blog/peyronies-treatments-traction-therapy-and-veds

The World Journal of Men’s Health

Joice, Gregory A. and Arthur L. Burnett

“Nonsurgical Interventions for Peyronie's Disease: Update as of 2016”

(Full-text. Published online: August 23, 2016)

https://synapse.koreamed.org/DOIx.php?id=10.5534/wjmh.2016.34.2.65