A review of various
treatment options
History
& background of Peyronie’s disease
Peyronie’s disease accounts
for 0.3 to 0.7% of all urinary system related disorders and it occurs most
often in the fourth to sixth decades of life, and occasionally in men less than
20 year old. A small number of men with Peyronie’s disease will get better
without treatment but drug therapy or radiation are normally used. Most of the
medical and surgical treatments, however, are designed to improve the symptoms
of the disease rather than to cure it. The following article is a short review of
all the major treatment options that are currently being used to treat or cure
Peyronie’s disease.
Medical
drug treatment
Medical drug treatment of
Peyronie’s disease can be of two types:
Oral
therapy: Oral medication therapy is only effective in the early,
or the acute phase of Peyronie’s. Thus, within the first year of developing a
plaque, drugs like PABA, vitamin E and colchicine are considered as effective
first line treatments. However, after
one year with a plaque, oral medications are rarely helpful.
Injection
therapy: If the condition is not improved by oral drug
treatment, doctors may prescribe intralesional injections with Verapamil,
interferons or steroids. The penis is
anesthetized initially and then the medication is injected into several sites
within the Peyronie’s Plaque. Following
a series of 6 injections spaced at least every other week, 2/3 of men have
improvement in their curvature, and 80% have improved erections. Verapamil and
interferon alpha-2b seem to diminish curvature of the penis. On the other
hands, these drugs are not free of some serious side effects. Steroids, such as cortisone, have frequently
produced unwanted side effects, such as the atrophy or death of healthy
tissues.
Surgery:
If
injections fail, surgical removal of the plaque and reconstruction can be
performed. While surgery is successful
at correcting the curvature of penis, it rarely improves the erectile dysfunction
and is also risky (because of high risk of associated complications) and costly
(very expensive).
Extracorporeal
Shock Wave Therapy
Extracorporeal shockwave
therapy (ESWT) uses vibrations caused by sound waves to treat the affected
tissue. The sound waves come from a device applied to the outside of the body
that generates short bursts of sound, called ‘sonic pulses’. The plaques on the
penis are targeted, normally using ultrasound as a guide.
Radiotherapy
Radiotherapy
Radiation therapy, in which high-energy rays are aimed at the plaque, has also been used. Like some of the chemical treatments, radiation appears to reduce pain, but it has no effect on the plaque itself and can cause unwelcome side effects such as erectile dysfunction.
The key question in the treatment of Peyronie’s disease probably is can we prevent disease progression resulting in penile shortening and curvature without surgery? None of the currently available treatment modalities so far has so demonstrated this effect conclusively. Use of traction based extenders or penis stretchers (e.g. SizeGenetics), however, does offer an attractive, economical, safe and natural option that has been found to have a role in correcting and preventing the abnormal curvature of the penis in many men.
SizeGenetics
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