When it comes to Peyronie’s Disease a physical exam is often sufficient to identify the presence of scar tissue in the penis and diagnose Peyronie’s disease. Rarely, other conditions cause similar symptoms and need to be ruled out. Tests to diagnose Peyronie’s disease and understand exactly what is causing your symptoms may include:
- A physical exam
- An ultrasound
Your doctor might recommend a wait and see approach if:
- The curvature of your penis isn’t severe and is no longer worsening
- You can still have erections and sex with no or mild pain
- You have good erectile function
If your symptoms are severe or are worsening over time, your doctor might recommend medication or surgery.
A number of oral medications 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. 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’ll 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.
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 a forcible bending of the penis in the opposite direction of the bend.
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.
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.