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Peyronie's Disease

 

Review of the conservative treatment options for Peyronie’s disease

Unfortunately, at this time, no conservative treatment has been comprehensively developed and tested that is as effective in dissolving plaque as the natural healing mechanism is.

Our doctors have carried out extensive research on the efficacy of different conservative treatments. The main conclusions of this research are summarised below. If you have any questions or concerns about these treatments then we are more than happy to answer these. We do advise patients, considering following any of these treatments, to do so under appropriate medical supervision and never self-administered. Some of these treatments may have side-effects and objective medical monitoring is necessary to identify potential benefits.

Oral medication for Peyronie’s disease

A number of oral drugs and supplements have been proposed and discussed to treat Peyronie’s disease. Unfortunately, none of these has displayed significant therapeutic benefits in comparison with placebo research studies. Some have shown some promise and given the minimal side-effects reported, these can be taken by patients. Below we present the most common oral treatments and our assessment of these options:

Vitamin E and propionyl-L-carnitine in isolation and combination

The efficacy of Vitamin E and propionyl-L-carnitine supplements in isolation and combination has proven to be no better than a placebo. We do consider this treatment option as ineffective.

Prescription Drugs

Colchicine is an antigout agent that inhibits scarring however studies suggest that it has no significant effect on Peyronie’s disease.

Potaba has shown some limited promise in inhibiting the development of plaques. However, t is also associated with severe gastrointestinal side effects and it is relatively expensive and as such we do not recommend it as a treatment option.

Tamoxifen citrate

This is another compound that potentially inhibits scarring but studies have not confirmed this theory yet so its administration is not currently recommended for Peyronie’s disease.

Pentoxifylline

Twice daily administration of 400mg of Pentoxifylline has shown to benefit some patients, resulting in a moderate reduction in plaque size and curvature. The cost of the medication is relatively low and although there are some potential side effects, it is one of the treatments that patients can experiment with during the acute phase of Peyronie’s.

Supplements

Coenzyme Q10

Daily intake of 300mg of Coenzyme Q10 has shown to result in a moderate decrease in plaque size and curvature as well as inhibiting disease progression. Although further research is required, the results to date are quite encouraging and given the low cost and minimal side-effects, we recommend coenzyme Q10 as a potential conservative treatment option during the acute phase of the condition.

Acetyl-L-carnitine

Similarly to Coenzyme Q10, initial studies have shown improvements in pain and curvature from daily intake of Acetyl-L-carnitine. Again further investigation is necessary but given the limited side-effects and low costs, we recommend its use as it might help some patients at this particular stage of Peyronie’s disease.

PDE5-Inhibitors

For patients suffering from a combination of erectile dysfunction and Peyronie’s, daily administration of Cialis 5mg is recommended. This is not only to help patients achieve erections for intercourse (which may not be possible due to curvature) but also non-coital erections can be beneficial with respecting to preventing further deterioration in erectile function (due to increased blood flow) and curvature (if accompanied by mechanical modelling)

Non-steroidal anti-inflammatory medications

These are over the counter medications such as Ibuprofen which can help with the management of pain during the acute phase.

Topical treatments for Peyronie’s Disease

Extracorporeal Shock Wave Lithotripsy (ESWL) for Peyronie’s Disease

There has been extensive research into whether ESWL can have beneficial effects for patients with Peyronie’s disease in a similar way that it has for patients suffering from erectile dysfunction. We were one of the first clinical groups to adopt this new technology for Peyronie’s and unfortunately, the results have been disappointing. In particular, plaque size and curvature were complete although, n some patients, a reduction in pain has been recorded. As such we do not consider ESWL as an effective treatment option for Peyronie’s disease given the associated cost involved.

Transdermal Verapamil Gel

Transdermal Verapamil Gel is a prescription compounded medication that is applied directly to the skin twice a day. There are some studies indicating moderate effectiveness in slowing down the progress of Peyronie’s symptoms but the body of evidence to support this so far is limited. For this reason, we do not consider it an effective treatment option.

Other topical treatments

Alternate treatments have been proposed such as applying heat to the plaques. However, there is currently no proven scientific study or insufficient evidence to support any other topical treatments at this point. We are at the leading point in research into this condition and our infield experts are exploring all new innovations and treatment options for our patients.

I am suffering from a what I suspect is Peyronies disease, what should I do next?

If you believe you are suffering from Peyronies and it causes you significant concern we advise you to see a specialist urologist/andrologist.


Our doctors have vast experience treating Peyronies and our clinic is an international referral centre for patients suffering from this condition. We would be happy to review your case and treat you in our clinic.

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We would like to reassure you that International Andrology remains fully operational during the lockdown and that as per the government directions, patients can travel to attend medical appointments and treatments. If you are unable to travel, you can have your medical appointment over video or phone.