Which Treatment is Most Effective in Treating Peyronie’s Disease?
There are a number of oral medications that have been tried to treat Peyronie’s disease, but they have not been shown to be effective consistently and are not as effective as surgery. Pentoxifylline is an oral medication used for Peyronie’s disease. When taken for several months, the medication may reduce the amount of scar tissue, though exactly how it does so isn’t known.
In some cases, drugs injected directly into the penis might reduce curvature and pain associated with Peyronie’s disease. Depending on the therapy, you might be given a local anaesthetic to prevent pain during the injections. If you have one of these treatments, you will likely receive multiple injections over several months. Evidence on the effectiveness of penile injections is limited. These medications may also be used in combination with oral drugs.
Collagenase– The only FDA approved medication for Peyronie’s disease is collagenase clostridium histolyticum. This medicine has been approved for use in adult men with moderate to severe curvatures and a palpable nodule. This therapy has been shown to improve curvature and bother associated with Peyronie’s disease. The treatment works by breaking down the buildup of collagen that causes penile curvature. Collagenase appears to be more effective when used in conjunction with “modelling,” which is forcible bending of the penis in the opposite direction of the bend.
Verapamil – This is a drug normally used to treat high blood pressure. It appears to disrupt the production of collagen, a protein that might be a key factor in the formation of Peyronie’s disease scar tissue. The drug is well tolerated and seems to reduce pain too.
Interferon – This is a type of protein that appears to disrupt the production of fibrous tissue and help break it down. One placebo-controlled trial showed improvement using this therapy over placebo.
Now on to some of the surgery options:
Incision or excision and grafting – With this type of surgery, the surgeon makes one or more cuts in the scar tissue, allowing the sheath to stretch out and the penis to straighten. The surgeon might remove some of the scar tissue.
Penile Implants – Surgically inserted penile implants replace the spongy tissue that fills with blood during an erection. The implants might be semirigid – manually bent down most of the time and bent upward for sexual intercourse. Another type of implant is inflated with a pump implanted in the scrotum. If you have both Peyronie’s disease and erectile dysfunction penile implants might be considered. The surgeon might perform additional procedures to improve the curvature if needed when the implants are put in place.
The type of surgery used will depend on your condition. Your doctor will consider the location of scar tissue, the severity of your symptoms and other factors. If you are uncircumcised, your doctor might recommend a circumcision during surgery.
Depending on the type of surgery you have, you might be able to go home from the hospital the same day or you might need to stay overnight. Your surgeon will advise you on how long you should wait before going back to work – in most cases, a few days. After surgery for Peyronie’s disease, you will need to wait four to eight weeks before sexual activity.
If you think you might have Peyronie’s Disease get in touch now and see how we can help you.