Peyronie disease (cont.)

Our Peyronie's Disease (Curvature of the Penis) Main Article provides a comprehensive look at the who, what, when and how of Peyronie's Disease (Curvature of the Penis)

Treatment: Because the course of the disease is different in each patient and because some patients experience improvement without treatment, experts usually recommend waiting 1 to 2 years or longer before attempting to correct it surgically.

No controlled studies have established the effectiveness of vitamin E therapy. Similar inconclusive success has been attributed to oral application of para-aminobenzoate, a substance belonging to the family of B-complex molecules. Researchers have injected chemical agents such as verapamil, collagenase, steroids, and calcium channel blockers directly into the plaques. These interventions are still considered unproven because studies have included low numbers of patients and have lacked adequate control groups. Steroids, such as cortisone, have produced unwanted side effects, such as the atrophy or death of healthy tissues.

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 at all on the plaque itself and can cause unwelcome and serious side effects.

Surgery: Peyronie disease has been treated with some success by surgery. The two most common surgical methods are removal or expansion of the plaque followed by placement of a patch of skin or artificial material, and removal or pinching of tissue from the side of the penis opposite the plaque, which cancels out the bending effect. The first method can involve partial loss of erectile function, especially rigidity. The second method, known as the Nesbit procedure, causes a shortening of the erect penis.

Some men choose to receive an implanted device that increases rigidity of the penis. In some cases, an implant alone will straighten the penis adequately. In other cases, implantation is combined with a technique of incisions and grafting or plication (pinching or folding the skin) if the implant alone does not straighten the penis.

Most types of surgery produce positive results. But because complications can occur, and because many of the phenomena associated with Peyronie's disease (for example, shortening of the penis) are not corrected by surgery, most doctors prefer to perform surgery only on the small number of men with curvature so severe that it prevents sexual intercourse.


Last Editorial Review: 6/14/2012

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