What is Peyronie's Disease?
Peyronie's Disease (PD) is the most common cause of a crooked penis. It is acquired, meaning that it is not a condition that anyone is ever born with. PD is a fibrotic condition, and is multifactorial. It can be caused by sustained micro-trauma, specifically a product of sexual intercourse. While some patients remember having a particular injury during intercourse, most patients don't have any such memory.
How do I know if I have Peyronie's Disease?
Most men will notice that their penis is crooked, often pointing upwards, or upwards and to the side. In the initial stages of PD, there may be pain. There may also be a plaque, or hard, woody area of firmness. While PD can effect young men, it is more common with increased age. Also, certain medical conditions, such as diabetes seem to predispose some men towards PD.
How common is Peyronie's Disease?
It is present in 6%-9% of men. In patients who have had a prostatectomy, it's as high as 16%, and in diabetics it's 20%. Talking with a physician about such a delicate issue keeps many men from seeking treatment, so the actual number of patients may be even higher.
Is Peyronie's Disease dangerous?
PD is not a threat towards one's overall health. There is a correlation between PD and a condition known as Dupuytren's Contracture, which is a similar process that can effect the hand. Some men will develop such a severe bend, usually greater than 60 degrees, that they find it impossible to engage in intercourse. Others may note a reduction in size of their penis. Men may develop depression because of these challenges, and the variable, unpredictable course of Peyronie's.
Does Peyronie's Disease ever improve on its own?
The first 6 to 18 months is termed the acute inflammatory stage, when the plaques undergo changes-both good and bad. Fortunately, the pain usually resolves without any intervention. While some patients do experience spontaneous resolution, others can develop chronic problems with shortening, angulation deformities, and erectile dysfunction. Eventually the condition stabilizes, and enters the chronic stage.
Will any pills help cure Peyronie's Disease?
The clinical guidelines published by the American Urology Association largely discounts the use of any pill other than non-steroidal medication for pain. While Vitamin E, tamoxifen, procarbazine, omega-3 fatty acids have all been promoted, the evidence does not support their use. Peyronie's Disease (2015)
Are there any effective options for the treatment of Peyronie's Disease?
- The only non-surgical, FDA approved option for the treatment of PD is intralesional collagenase clostridium histolyticum (CCH (Xiaflex®) Although FDA approved, it is not without potential complications, which include bruising, swelling, and rupture of the corpora cavernosa. The success rate is 44-66%, and the cost averages $33,628.https://www.urologytimes.com/view/peyronies-treatments-costs-outcomes-compared
- Another alternative for patients who wish to be treated with injections is interferon α-2b. Although the AUA Guidelines find it to be an acceptable treatment option, the results suggest that the outcomes may not be as strong as Xiaflex. However, the safety profile is very favorable. https://pubmed.ncbi.nlm.nih.gov/11350406/#:~:text=Conclusions%3A%20Subcutaneous%20interferon%2Dalpha%202b,conservative%20treatment%20of%20Peyronie's%20disease. 3
- Surgery is the gold-standard, associated with the highest success rate. However, there are significant potential side effects, which can include erectile dysfunction, and shortening of the penis. Patients who suffer from erectile dysfunction, and PD often benefit from placement of a penile prosthesis.
Are Gainswave, non-focused radial wave therapy, or focused shockwave therapy effective treatments for Peyronie's Disease?
Using wave therapy alone (monotherapy) is probably not effective for the treatment of Peyronie's, other than for treatment of pain. There is a large body of literature that confirms this. https://uroshock.com/scientific-data-aggregation/ The AUA guidelines clearly state, "Clinicians should not use extracorporeal shock wave therapy (ESWT) for the reduction of penile curvature or plaque size." At Uroshock, we want our customers to have realistic expectations of outcomes, and we do not recommend wave therapy as monotherapy for the treatment of Peyronie's Disease.
Can a combination of different non-invasive treatments be effective therapy for Peyronie's Disease?
The use of a combination of treatments may prove to be beneficial, although there are no good studies available to support this position at this time. In particular, there is interest in combining traction therapy with shockwave treatments. Traction therapy utilizes a mechanical device-a penis extender- which is affixed to the phallus for hours at a time. There are a number of penis extenders that are often promoted for penis lengthening. Some urologists recommend their use prior to implantation of a penile prosthesis to prevent shrinkage following surgery.https://www.sciencedirect.com/science/article/pii/S2050116121000672