Penile Traction
Two recent studies have reported promising results for penile traction therapy as an adjunct to oral and intralesional therapy for PD. One small observational study using penile traction for men with curvature <50° demonstrated increased penile length (1.4 cm on average) and decreased curvature over 1 year of treatment. A second, recently published prospective, uncontrolled study of 11 men, combined intralesional verapamil with penile traction, applied, on average for 3.6 h/day, demonstrated subjective and objective decreases in penile curvature. While the small size of this study and the absence of a control group limit the conclusions one can draw from it, this pilot study supports the feasibility of this approach. One of the primary concerns of men with PD is the frequent loss of penile length. These mechanical devices may offer patients an effective way to minimize this feared and psychologically devastating symptom. Larger, controlled studies are necessary to verify these results; however, this therapy presents a novel approach to the treatment of PD that may be beneficial for many individuals. Read more about canadian pharmacy viagra here.
Shock Wave Therapy
Several groups have utilized shock wave therapy successfully to treat penile plaques and curvature. Local and/or regional anesthesia is needed occasionally for the procedure and while minor skin hematomas were very common (76%), both this adverse event and mild urethral bleeding (8%) resolved spontaneously. The only placebo-controlled trial for shock wave therapy demonstrated a reduction in penile pain without the improvement in penile curvature.
Summary of Nonsurgical Treatment Options
Data from the randomized trials evaluating intralesional injection or electrophoresis of verapamil are almost uniformly positive; however, their consistently low methodological quality limit the conclusions one can draw from them. Data for many oral medications are often equivocal; however, l-carnitine and Potaba™ suggest some benefit. Penile stretching devices and pentoxifylline are promising therapies that need to be assessed with larger, controlled studies to convincingly evaluate their effectiveness.
Key Points
- Peyronie’s disease is an acquired disorder of the penis resulting in varying degrees of penile curvature, deformity, and sexual disability.
- The diagnosis rests on a careful psychosexual history and physical exam.
- Ultrasonography is a useful tool to guide non-surgical treatment choices and plan surgical approaches.
- Numerous medical therapies have been utilized to treat Peyronie’s disease with only modest success.
- New therapies are needed that are effective, easy to administer, low-cost, and have few or no side effects.
