How can Peyronie’s disease be treated?

If you think you've got Peyronie’s disease, you’ve probably scanned the web and found countless treatment options already. Here we will list some, and go through each treatment based on the latest scientific evidence.

Treatment of Peyronie’s disease ranges from minimally disabling treatments to surgical intervention. There are treatments available that can help to reduce the curvature of the penis and go some way to restoring normal function.

Which treatment is right for me?
Finding the right treatment just for you is a matter of discussion with your doctor and largely depends on the severity of the curvature, which stage it’s in and how much it affects your life.

Non-surgical treatment options[1]


Intralesional injection therapy
An intralesional treatment means injecting a medical substance directly into a body part that is affected by a disease (lesion) – in the case of Peyronie’s disease that means, the collagen plaque that is causing the penis to bend. Depending on the degree and severity of the curvature, intralesional treatments can be used to reduce the curvature of the penis. Talk to your doctor to find out more.

Oral treatments
Several oral treatments are said to help against Peyronie’s disease. However, most of them are not supported by treatment guidelines for routine use in patients with Peyronie’s disease. This has to do with their lack of scientifically proven clinical effect.

Traction therapy
This may be done using a stretching device, or by use of a vacuum pump of the kind normally supplied for certain kinds of erectile dysfunction. As with the oral treatments, there are no good-quality studies that prove the benefit of this treatment. However, it may be possible that traction or vacuum therapy could be beneficial, especially when used along with other treatments.[2]

SURGERY[3]


Surgery has been used for many years for the treatment of Peyronie's disease. It is only used on men with Peyronie's disease that is in a stable phase with a disabling deformity, in other words when the curvature not getting worse, and is hindering sexual intercourse and a normally functioning life.

What type of surgery is it?
The goal of the surgery is to straighten out the curvature, preserve or restore the ability to have erections and the same time not affect the length and girth of the penis. Although, it’s important to remember that surgery won’t change the penis back to exactly how it looked and felt before Peyronie's disease was present. The type of surgery that is performed is dependent on where the Peyronie’s plaque is located, degree of curvature, how much the erectile function is impaired, what the patient prefers and also the surgeon’s experience. Since Peyronie’s disease is a condition that varies in presentation from man to man, no single surgical intervention can be used on all Peyronie's disease cases.

The different surgical procedures for Peyronie’s disease are:

- Tunical shortening
- Tunical lengthening
- Penile prosthesis implantation

Tunical shortening
This is suitable for patients with normal penile length and a curvature of less than 60 degrees. Tunical shortening means that the penis is physically straightened by the surgeon by operating on the side opposite to the plaque. Tunical shortening, such as the Nesbit procedure, is the most commonly performed surgery for Peyronie's disease.

Tunical lengthening
Suitable for patients with a more complex curvature deformity exceeding 60 degrees, large plaques and short length of the penis. Tunical lengthening is a form of reconstructive surgery that means cutting or completely removing the plaque in the penis. The space where the plaque was located is then filled with a graft.

Penile prosthesis implantation
In very severe cases, especially where the patient also has erectile dysfunction, the surgeon may offer to implant a prosthesis at the same time as straightening out the bend in the penis.

Sources:

  1. Sherer MD et al. (2015) Expert Opinion on Pharmacotherapy, 16:9, 1299-1311.
  2. Jordan GH, Carson CC, Lipshultz LI. BJU Int 2014;114:16–24.
  3. Culley C. Carson, Laurence A. Levine BJU Int 2014; 113: 704–713.