Peyronie’s Disease is common, but often treatable with new noninvasive options. Some studies suggest that Peyronies Disease (PD) may be as common as one in ten men. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8451611/
What Is Peyronie’s Disease?
Peyronie’s Disease is a connective tissue disorder that results in a bent penis. For many men, it a mild nuisance, but for others, it is painful, and may make it impossible to have pleasurable intercourse. Depending upon the degree of angulation, it may make sexual intercourse uncomfortable for the partner as well. The angulation deformity becomes most prominent when the patient has an erect penis, which of course, is often the worst possible time.
What Causes Peyronie’s Disease?
Most researchers feel that Peyronie’s Disease (PD) is a response to wound healing. It’s likely that during intercourse, there maybe micro-trauma, resulting in tearing of the corpora cavernosa. In other words, this can happen to anyone, and is not an implication of misbehavior. Never, ever feel guilty about having Peyronie’s Disease! Similarly, your partner didn’t do anything untoward to cause it! It’s as innocent as tennis elbow.
Will Peyronie’s Disease Get Better On It’s Own?
During the acute phase, which can last 12-18 months, the plaques may be unstable, and some will improve spontaneously. Unfortunately, once the plaque reaches the chronic phase, change becomes unlikely without some form of intervention.
Do I Need To Be Treated For Peyronie’s Disease?
Like erectile dysfunction, nobody ever died from PD. Many men have such a mild deformity, that they are not the least bit bothered by the condition. Men who have trouble with intercourse, or are frustrated by the physical appearance of their bent phallus can be treated with an ever growing arsenal of interventions.
Do Pills Like Viagra Or Cialis Help?
There is an increasing body of literature that suggests that combing pde5-inhibitors with other modalities, such as low intensity shockwave therapy may be helpful.
What Is Xiaflex And How Does It Work?
Xiaflex, collagenase clostridium histolyticum (CCH), is the only FDA approved treatment for PD. Xiaflex is injected by urologists into the plaque. Potential complications include urethral injury, rupture of the corpora cavernosa, and penile fracture. A popular protocol is 2 separate injections and 4 office visits over a 12 week period of time.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8451611/
Vacuum Erection Devices
Vacuum erection devices are commonly used for the treatment of erectile dysfunction. While generally regarded as very safe, they are also cumbersome and awkward when used in their intended environment. They are used by creating a vacuum, resulting in blood being trapped in the penis. In order to be used for intercourse, a constriction band is placed around the base of the penis as the plastic cylinder is removed from the penis. The FDA previously issued a warning that they may worsen a bent penis, although there are articles which refute this, and encourage their use in the treatment of PD.
Penis Traction Devices
A new penis traction device was created with the support of the Mayo Clinic, and the results were impressive. https://www.auajournals.org/doi/abs/10.1097/JU.0000000000000245
Unlike other devices, the RestoreX can be used for as little as 30-90 minutes per day.
Does Shockwave Therapy Have A Role In The Treatment Of Peyronie’s Disease?
Because of its noninvasive nature, and high tolerance among patients, there has been great interest in the use of shockwave therapy for Peyronie’s Disease. An aggregate of these studies is included in the scientific data section of this website. https://uroshock.com/scientific-data-aggregation/
The protocol for the treatment of PD is somewhat different than that for ED, in that the energy should be applied to the plaque from different directions, and obviously, rather than directing some of the energy to the crus, all of the energy is directed towards the palpable plaque. The only cordless, hand-held device which is also the most ergonomically friendly is the Uroshock PX3. https://uroshock.com/how-it-works/
Particularly in patients who are being treated with shockwave therapy for PD, there may be added benefit to combination therapy with pde5-inhibitors. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8788614/
Another alternative which has not been well studied is the combination of non-invasive treatments which could include penis traction, LiSWT, and pde5-inhibitors.