Materiały źródłowe

• #1 Peyronie disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/peyronies-disease/diagnosis-treatment/drc-20353473

  Treatment options for Peyronie disease depend on how long it’s been since you began having symptoms. […] For the acute phase of the condition, treatments include: […] Surgery is not recommended in the acute phase of Peyronie disease. It isn’t a treatment option until the condition stops becoming worse and any pain goes away. This lowers the chances of needing a second surgery. […] For the chronic phase of the disease, treatment choices include: […] Oral medications taken by mouth aren’t recommended in the chronic phase. They haven’t been shown to be effective at this stage of the disease. […] Oral medicines have been tried to treat Peyronie disease. But research has shown that many don’t work consistently, and they are not as effective as other treatments. […] Penile traction therapy involves stretching the penis with a mechanical device that you put on daily.

• #1 Early treatment for Peyronie’s disease – Mayo Clinic Health System

  https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/early-treatment-for-peyronies-disease

  Peyronie’s disease is a common yet poorly understood condition. Between 8% and 10% of men in their mid-teens to their 80s have signs or symptoms of Peyronie’s disease. […] Early evaluation and treatment is important, as Peyronie’s disease rarely goes away on its own. Without treatment, only about 10% to 15% of men experience symptom relief in one year, while symptoms worsen for about 45% of men. […] Early diagnosis and treatment may be able to halt or treat the curvature with nonsurgical means. This is why it’s important to seek treatment early. […] Most often, treatment in the acute phase may include: Penile traction therapy This involves stretching the penis with a self-applied device to improve penile length and curve while correcting any deformity. It is worn for as little as 30 minutes to as much as eight hours a day. It’s the only treatment shown to improve penile length.

• #1 Peyronie’s Disease Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/peyronies-disease-guideline

  4. Clinicians should discuss with patients the available treatment options and the known benefits and risks/burdens associated with each treatment. (Clinical Principle) […] 5. Clinicians may offer oral non-steroidal anti-inflammatory medications to the patient suffering from active Peyronie’s disease who is in need of pain management. (Expert Opinion) […] 6. Clinicians should not offer oral therapy with vitamin E, tamoxifen, procarbazine, omega-3 fatty acids, or a combination of vitamin E with L-carnitine. [Moderate Recommendation; Evidence Strength Grade B(vitamin E/omega-3 fatty acids/Vitamin E + propionyl-L-carnitine )/ C( tamoxifen/procarbazine)] […] 8. Clinicians may administer intralesional collagenase clostridium histolyticum in combination with modeling by the clinician and by the patient for the reduction of penile curvature in patients with stable Peyronie’s disease, penile curvature 30 and 90, and intact erectile function (with or without the use of medications). (Moderate Recommendation; Evidence Strength Grade B)

• #1 Peyronie’s disease – Watch out for the bend

  https://www.racgp.org.au/afp/2017/september/peyronies-disease

  Peyronies disease is a relatively common condition in urological practice, but is still poorly identified and understood in the wider medical community and by most of the public. […] Oral therapy is usually of limited efficacy, while penile traction may only be beneficial in motivated patients. Intralesional injections of collagenase were recently introduced as a non-surgical measure to decrease penile curvature. Surgery remains the most effective treatment for Peyronies disease and is considered the gold standard. […] There is no oral agent that cures Peyronies disease and most of the commonly used treatments that patients source from, or investigate on the internet, have had no efficacy in proper clinical trials. […] Pentoxifylline is a nonspecific phosphodiesterase inhibitor that may increase penile levels of nitric oxide and may prevent, or reverse, calcification of the Peyronies plaque.

• #1 Peyronie’s disease – Watch out for the bend

  https://www.racgp.org.au/afp/2017/september/peyronies-disease

  Phosphodiesterase type-5 (PDE5) inhibitors that are available in Australia are sildenafil, tadalafil and vardenafil. […] Agents that are injected into the plaque have more promise for improvement, and are now widely studied and accepted as worthwhile treatments. […] The use of intralesional injections of collagenase, plus physical modelling of the penis, have been reported to cause decreases in curvature. […] Verapamil has been found to affect fibroblast cellular activity. Some studies have found that intralesional verapamil injection induces a significant reduction in penile curvature. […] Low-intensity shockwave therapy for the treatment of Peyronies disease has been found to have only very minor benefit. […] In several tissue models, including Dupuytrens scar, gradual expansion of tissue by traction has been found to result in the formation of new connective tissue by cellular proliferation.

• #1 Peyronie disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/peyronies-disease/diagnosis-treatment/drc-20353473

  Traction therapy is recommended in the early phase of Peyronie disease. It’s the only treatment shown to improve penis length. Traction therapy also may be used in the chronic phase of the disease, combined with other treatments or after surgery for a better outcome. […] Your doctor might suggest surgery if the curve or bend of your penis is severe, bothers you a lot or prevents you from having sex. […] Common types of surgery for Peyronie disease include: […] The type of surgery used depends on your condition. […] Before you get surgery for Peyronie disease, ask your surgeon about the risks. […] Researchers continue to explore other treatments for Peyronie disease. Evidence is limited on how well they work and what their side effects might be. Examples include use of intense sound waves to break up scar tissue, stem cells, platelet-rich plasma and radiation therapy. Currently, these therapies are considered experimental.

• #1 Oral therapy for Peyronie’s disease, does it work? – Barrett-Harlow – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10425/html

  Similarly, the 2010 International Consultation on Sexual Medicine did not support the routine clinical use of oral agents for PD. […] Two oral medications not restricted by the guidelines are PDE-5 inhibitors and PTX. Further research on PDE-5 and PTX, to include large multi center double blind, randomized-control trials, are needed to determine their efficacy.

• #1 Peyronie’s Disease: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/10044-peyronies-disease

  Peyronies disease treatment options include: […] Traction therapy […] These therapies utilize an external device, such as a vacuum erection device or traction device (RestoreX), to gently stretch your penis and sometimes even bend it in the opposite direction of the curve. It encourages the scar tissue to break down and can: […] Improve curvature. […] Restore lost length. […] Increase erection hardness. […] Most people need to use the traction therapy device for several months to see improvement. […] There are generally no long-term side effects of properly using a traction therapy device. […] A healthcare provider may recommend medications you take by mouth (oral medications) or inject into your penis. Providers usually recommend medications if you have acute Peyronies disease or if you’re not sure if you want surgery. However, they rarely result in a straight penis.

• #1 Penile Curvature (Peyronie’s Disease) – NIDDK

  https://www.niddk.nih.gov/health-information/urologic-diseases/penile-curvature-peyronies-disease

  How do health care professionals treat Peyronies disease? The goal of treatment is to reduce pain, attain a straight or close-to-straight penis, and restore and maintain the ability to have intercourse. […] If you need treatment, your urologist may recommend nonsurgical treatments or surgery depending on the severity of your symptoms, how much your penis curves, and whether your Peyronies disease is in the acute or chronic phase. […] Nonsurgical treatments include injections, oral medicines, and medical therapies. They may be used when Peyronies disease is in the acute phase. […] Injecting a medicine directly into plaques, called intralesional injections, can be done in the acute phase. […] Intralesional collagenase injections (Xiaflex) are currently the only FDA-approved treatment for Peyronies disease.

• #1 Peyronie’s Disease: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/10044-peyronies-disease

  Injection medications may include: […] Collagenase injections (Xiaflex). A provider may prescribe collagenase injections if the curve in your penis is greater than 30 degrees to help break down scar tissue. […] Surgery […] Healthcare providers only recommend surgery if you have severe Peyronies disease that makes it difficult or impossible to have sex. […] You should only have surgery if you’re in the stable or chronic phase of Peyronies disease, in which the scarring and curvature no longer progress and you haven’t had any pain for between six and 12 months. […] Peyronies disease surgery options include: […] Shortening the unaffected side of your penis. […] Making the side of your penis on the inside of the curve longer. […] Penile implant. […] It depends on the severity of your condition and what type of treatment you receive. A healthcare provider will give you an estimate on when you can expect to feel better after treatment.

• #1 Treatment of Peyronie’s Disease < Sexual and Reproductive Medicine Blog

  https://medicine.yale.edu/lab/urology-mens-health-blog/2022/mar/

  Intralesional verapamil is one of the treatment options available for peyronies disease. It is not FDA approved for this indication and therefore is considered an off label treatment. Published data suggests that 50% of patients will have some improvement in penile curvature and 50% will not. If curvature improvement is present usually modest, maybe 10-15 degree improvement. Occasionally, significant improvement can occur. It is a series of six injections which occur every two weeks. Side effects are uncommon and include mild swelling and bruising to the penis. Theres no limitation sexually in between treatments. […] Collagenase or Xiaflex is FDA approved for patients with peyronies disease and curvature between a30-90 degrees angle. The published data suggests that 70% of men will have a combination of improvement of patient bother and/or improvement in curvature after four treatments cycles. Each cycle consists of two collagenase injections separated by 3- 7days. This is followed by penile modeling or bending of the penis (done 3x daily for 30 seconds)- every day starting 2 days after the second treatment. This cycle is repeated 4 times. There should be no sexual activity for 4 weeks after the second treatment in the cycle.

• #1 Medical Management of Peyronie’s Disease: Review of the Clinical Evidence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6780399/

  The present article reviews the clinical evidence for the medical management of Peyronies disease, including intralesional therapy, mechanical therapy, ESWT, oral therapy, and topical therapy. […] A recent systematic review concluded that the currently available clinical evidence from randomized trials only supports collagenase clostridium histolyticum (CCH) and IFN-2b as being capable of improving penile curvature in patients with Peyronies disease. […] The best evidence of improvement of curvature in Peyronies disease exists for collagenase clostridium histolyticum. […] Intralesional interferon -2b has been shown to be superior to a placebo in improving penile curvature and plaque size in two small placebo-controlled studies. […] Currently, there is no good-quality evidence from randomized studies to support the use of verapamil.

• #1 Medical Management of Peyronie’s Disease: Review of the Clinical Evidence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6780399/

  A single randomized controlled study assessing hyaluronic acid has been reported. […] Intralesional steroids have not been shown to have an advantage over a placebo in randomized studies. […] A network meta-analysis of eight randomized controlled studies suggested that in regards to penile curvature, CCH and interferon -2b are associated with better outcomes than verapamil or hyaluronic acid. […] In summary, mechanical therapy is now supported by randomized controlled trials in the acute and stable phase of Peyronies disease to improve penile curvature. […] The use of extracorporeal shock wave therapy (ESWT) for the reduction of penile curvature or plaque size is not recommended. […] To date, no oral treatment has proven to be effective in improving penile curvature in patients with stable disease.

• #1 Peyronie’s Disease Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/peyronies-disease-guideline

  10. Clinicians may administer intralesional interferon -2b in patients with Peyronie’s disease. (Moderate Recommendation; Evidence Strength Grade C) […] 12. Clinicians may offer intralesional verapamil for the treatment of patients with Peyronie’s disease. (Conditional Recommendation; Evidence Strength Grade C) […] 14. Clinicians should not use extracorporeal shock wave therapy (ESWT) for the reduction of penile curvature or plaque size. (Moderate Recommendation; Evidence Strength Grade B) […] 15. Clinicians may offer extracorporeal shock wave therapy (ESWT) to improve penile pain. (Conditional Recommendation; Evidence Strength Grade B) […] 18. Clinicians may offer tunical plication surgery to patients whose rigidity is adequate for coitus (with or without pharmacotherapy and/or vacuum device therapy) to improve penile curvature. (Moderate Recommendation; Evidence Strength Grade C)

• #1 Penile Curvature (Peyronie’s Disease) – NIDDK

  https://www.niddk.nih.gov/health-information/urologic-diseases/penile-curvature-peyronies-disease

  A urologist may recommend surgery to remove plaque or help straighten the penis during an erection. […] Medical experts recommend you dont have surgery until your plaque and penis curving stabilize. […] In this surgery, your urologist will remove the plaque and replace it with a patch of tissue that was taken from another part of your body, such as skin or a vein from your leg; grown in a laboratory; or from organ donors. […] In plication surgery, your urologist will remove or pinch a piece of the tunica albuginea from the side of the penis opposite the plaque to help straighten the penis. […] Penile implants may be considered if a man has both Peyronies disease and ED.

• #1 Treatment of Peyronie’s Disease < Sexual and Reproductive Medicine Blog

  https://medicine.yale.edu/lab/urology-mens-health-blog/2022/mar/

  This surgical procedure allows for improvement in curvature to the penis. It is usually performed as an outpatient procedure and involves putting stitches on the opposite side of the penis that is curved. It does not remove the scar tissue. In the experience of the Yale Urology, we can correct approximately 65 curvature to the penis with this therapy. Post operatively, no sexual activity or stimulation is allowed for approximately six weeks. […] This operation is usually recommended in patients who have over a 70 curvature to the penis. It is recommended that this be performed by a urologist who has expertise in reconstructive surgery or sexual medicine. It is an outpatient procedure and sexual activity can be resumed approximately six to eight weeks after surgery. […] For patients with a combination of non resolvable erectile dysfunction and penile curvature from peyronies disease, a penile prosthesis is the recommended treatment of choice. […] The Yale Urology team offers all these treatments in men who have intact erectile function and peyronies disease. We have extensive experience with all these treatment options.

• #1 Get Peyronie’s Disease Treatment | Cleveland Clinic

  https://my.clevelandclinic.org/services/peyronies-disease-treatment

  Penile plication: During penile plication, we cut out or fold tissue on the curved side of your penis and secure it with stitches. Tightening the skin helps straighten your penis. The procedure can make the penis shorter, but its less likely than grafting to cause ED. […] If you have a curved penis and ED, your provider might recommend surgical penile implants (penile prostheses). Most implants are inflatable pumps that you can control when youre ready to have sex. In some cases, we do penile grafting or plication at the same time as the implantation procedure.

• #1 Peyronie’s Treatment in Houston, TX | Jonathan Clavell, MD

  https://houstonmenshealth.com/conditions/peyronies-disease/

  In this type of surgery, your surgeon will make a cut, or incision, in the plaque, which will allow the penis to stretch out and become straight. In certain occasions, the plaque may be removed, or excised. When this is done, a piece of biologic tissue (graft) is sewn into place to cover the defect left by the incision or excision. This procedure is used in cases with severe curvature or deformity and comes with a greater risk of erectile function but less risk of penile shortening. […] The penile prosthesis is placed inside the penis and sometimes, is strong enough to overcome a mild to moderate curvature. Penile implant is a good option for patients with both Peyronies disease and erectile dysfunction. When the implant is put in place, Dr. Clavell might perform additional procedures to improve the curvature if needed. […] Dr. Clavell provides innovative and state-of-the-art treatments tailored specifically to your needs and goals. He is fellowship-trained in surgical and reconstructive techniques for Peyronies Disease that make him unique in the field of urology.

• #1 Peyronie’s Disease Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/peyronies-disease-guideline

  19. Clinicians may offer plaque incision or excision and/or grafting to patients with deformities whose rigidity is adequate for coitus (with or without pharmacotherapy and/or vacuum device therapy) to improve penile curvature. (Moderate Recommendation; Evidence Strength Grade C) […] 20. Clinicians may offer penile prosthesis surgery to patients with Peyronie’s disease with erectile dysfunction (ED) and/or penile deformity sufficient to prevent coitus despite pharmacotherapy and/or vacuum device therapy. (Moderate Recommendation; Evidence Strength Grade C) […] 22. Clinicians should use inflatable penile prosthesis for patients undergoing penile prosthetic surgery for the treatment of Peyronie’s disease. (Expert Opinion)

• #1 Treatments for Peyronie’s Disease | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/mens-health/peyronies-disease/treatments.html

  Peyronie’s disease rarely gets better on its own. For men who have a slight curve that isn’t getting worse and who have good erectile function, treatment usually is not needed. But if pain is a problem, or if the curve is getting worse and interfering with your sexual activity, then getting treatment may help. And early treatment during the acute phase may also work better than waiting until you’re in the chronic phase. […] Medicines may help treat pain and reduce how much the penis curves. They include: […] Surgery is only considered for men who have severe pain, a severely curved penis, or sexual dysfunction related to Peyronie’s disease. Surgical options include removing the scar tissue or shortening the unaffected side of the penis (plication). […] In some cases, a penile prosthesis may be used to help keep an erection during intercourse.

• #1 Peyronie Disease Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative Details

  https://emedicine.medscape.com/article/456574-treatment

  In a review of treatment for PD, Capoccia and Levine recommended that the optimal non-surgical treatment involves a combination of oral, intralesional, and external traction therapies. However, they concede that the optimal combination of medications remains elusive. […] The calcium channel blocker verapamil has gained attention for the treatment of PD since Lee and Ping found that it induced increased collagenase activity. […] If the plaque is located distally and the angulation is not very severe, a plication procedure can be offered. […] When the penile length or the patient’s preference precludes the use of penile plication and if the patient retains erectile ability, then an incision or excision of the plaque can be considered with grafting to reconstruct the tunica albuginea. […] The ideal graft material, which should be durable while elastic and tough but flexible, has not yet been identified.

• #1 Nonsurgical treatment shows advantages in Peyronie’s disease | Wolters Kluwer

  https://www.wolterskluwer.com/en/news/nonsurgical-treatment-shows-advantages-in-peyronies-disease

  For men with Peyronie’s disease (PD), nonsurgical treatment including injections of collagenase clostridium histolyticum (CCH) produces high satisfaction with sexual outcomes with fewer adverse events compared to surgery, reports a clinical trial in the October issue of The Journal of Urology, an official journal of the American Urological Association (AUA). […] In 2014, the US Food and Drug Administration approved CCH as a nonsurgical alternative. Treatment includes injections of CCH, with the aim of breaking down the plaque tissue causing the penile curvature. […] Nonsurgical treatment included CCH injections, followed by the use of a traction device (RestoreX) to help stretch and shape the penis plus the oral medication sildenafil. […] After three months, 50% of men assigned to CCH reported being „very satisfied” with their outcomes, compared to 21% in the surgery group. […] Although surgery produces greater improvement in penile curvature, sexual function and overall patient satisfaction appear higher with CCH injection therapy.

• #1 Peyronie disease – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/peyronies-disease/symptoms-causes/syc-20353468

  Peyronie disease rarely goes away on its own. In most people with the condition, it will remain as is or may get slightly worse early on. Early treatment soon after you get the condition may keep it from getting worse or even improve symptoms. […] Even if you’ve had Peyronie disease for some time, treatment may help ease symptoms such as pain, curving and shortening. […] See a health care professional if you notice symptoms of Peyronie disease. Early treatment gives you the best chance to improve the condition or keep it from getting worse. […] Our caring team of Mayo Clinic experts can help you with your health concerns. Visit Mayo Clinic Men’s Health to get started. […] Traction Therapy Device for Peyronie’s Disease. […] Surgical management of Peyronie’s disease. […] Efficacy of combined collagenase clostridium histolyticum and RestoreX penile traction therapy in men with Peyronie’s disease.

• #1 What Causes Peyronie’s Disease and Is it Treatable? | University of Utah Health

  https://healthcare.utah.edu/the-scope/health-library/all/2019/08/what-causes-peyronies-disease-and-it-treatable

  With traction therapy, this is something that men can do at home. […] I actually don’t use oral therapies very much, and we don’t use them very much in our practice here in Utah because our professional society, the American Urological Association, in 2015, came out with guidance that they don’t really work. […] Injection therapies are drugs that we inject directly into this scar tissue that can either help dissolve it or prevent more of it from forming. […] Surgery, there are numerous surgical options. […] You need to talk to your patient and figure out how much they want treatment, and how quickly and, you know, ultimately how much time they’re willing to devote to treatment, and how aggressive they want to get will help determine what they end up doing. […] I would encourage guys to come in, at least have a discussion because that way you can know what the evidence is, one way or another, and make your decision based on a level playing field. […] If a man has not seen a male sexual dysfunction specialist, so somebody who is specifically trained in managing these types of conditions, and there are a handful of us across the country, then they should seek someone out like that.

• #2 Penile Curvature (Peyronie’s Disease) – NIDDK

  https://www.niddk.nih.gov/health-information/urologic-diseases/penile-curvature-peyronies-disease

  How do health care professionals treat Peyronies disease? The goal of treatment is to reduce pain, attain a straight or close-to-straight penis, and restore and maintain the ability to have intercourse. […] If you need treatment, your urologist may recommend nonsurgical treatments or surgery depending on the severity of your symptoms, how much your penis curves, and whether your Peyronies disease is in the acute or chronic phase. […] Nonsurgical treatments include injections, oral medicines, and medical therapies. They may be used when Peyronies disease is in the acute phase. […] Injecting a medicine directly into plaques, called intralesional injections, can be done in the acute phase. […] Intralesional collagenase injections (Xiaflex) are currently the only FDA-approved treatment for Peyronies disease.

• #2 Peyronie disease – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/peyronies-disease/symptoms-causes/syc-20353468

  Peyronie disease rarely goes away on its own. In most people with the condition, it will remain as is or may get slightly worse early on. Early treatment soon after you get the condition may keep it from getting worse or even improve symptoms. […] Even if you’ve had Peyronie disease for some time, treatment may help ease symptoms such as pain, curving and shortening. […] See a health care professional if you notice symptoms of Peyronie disease. Early treatment gives you the best chance to improve the condition or keep it from getting worse. […] Our caring team of Mayo Clinic experts can help you with your health concerns. Visit Mayo Clinic Men’s Health to get started. […] Traction Therapy Device for Peyronie’s Disease. […] Surgical management of Peyronie’s disease. […] Efficacy of combined collagenase clostridium histolyticum and RestoreX penile traction therapy in men with Peyronie’s disease.

• #2 Peyronie’s Disease | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.peyronie’s-disease.tv7745spec

  Peyronie’s disease can sometimes get better without treatment during the acute phase. […] Once the disease is stable and the chronic phase begins, it usually doesn’t get better on its own. If you have a slight curve that isn’t getting worse and have good erectile function, treatment usually is not needed. But if pain is a problem, or if the curve is getting worse and interfering with your sexual activity, then getting treatment may help. […] Most people are able to remain sexually active. Counseling can help you maintain an active sexual life. […] Medicines, such as NSAIDS, may help treat pain. […] Surgery is only considered if you have a severely curved penis or sexual dysfunction related to Peyronie’s disease. Surgical options include removing the scar tissue or shortening the unaffected side of the penis (plication). Experts usually suggest that before trying surgery, you wait at least a year. […] If a penis is severely curved with poor erections, a penile prosthesis may be used to help straighten the penis and keep an erection during intercourse.

• #2 Peyronie disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/peyronies-disease/diagnosis-treatment/drc-20353473

  Treatment options for Peyronie disease depend on how long it’s been since you began having symptoms. […] For the acute phase of the condition, treatments include: […] Surgery is not recommended in the acute phase of Peyronie disease. It isn’t a treatment option until the condition stops becoming worse and any pain goes away. This lowers the chances of needing a second surgery. […] For the chronic phase of the disease, treatment choices include: […] Oral medications taken by mouth aren’t recommended in the chronic phase. They haven’t been shown to be effective at this stage of the disease. […] Oral medicines have been tried to treat Peyronie disease. But research has shown that many don’t work consistently, and they are not as effective as other treatments. […] Penile traction therapy involves stretching the penis with a mechanical device that you put on daily.

• #2 Peyronie’s Disease Santa Monica: What is Peyronie’s Disease? Symptoms, Treatment, Diagnosis – The Men’s Clinic at UCLA | UCLA Health

  https://www.uclahealth.org/medical-services/urology/mens-clinic-ucla/peyronies-disease

  The Mens Clinic at UCLA is a world leader in Peyronies Disease (PyD) treatment, management and research. […] Dr. Mills has been successfully managing PyD patients with XIAFLEX injectors since its FDA approval in 2013. […] Peyronies Disease, a disfiguring, bothersome bend in a mans erect penis, is a complex condition with no clear cause and a multitude of treatment options. […] Treatment strategies will depend on how long the man has had the condition prior to seeking medical advice, how severe the deformity is, how good his erections are and how bothered the man is by the disease. […] Dr. Mills frequently states the penis chooses the treatment. […] Most Peyronies disease specialists initiate treatment with medical therapy, usually pills or topical creams to the penis. […] Many specialists prescribe pentoxyphyline, a drug initially used to improve blood flow to the legs of patients with vascular insufficiency.

• #2 Peyronie’s Disease: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/10044-peyronies-disease

  Injection medications may include: […] Collagenase injections (Xiaflex). A provider may prescribe collagenase injections if the curve in your penis is greater than 30 degrees to help break down scar tissue. […] Surgery […] Healthcare providers only recommend surgery if you have severe Peyronies disease that makes it difficult or impossible to have sex. […] You should only have surgery if you’re in the stable or chronic phase of Peyronies disease, in which the scarring and curvature no longer progress and you haven’t had any pain for between six and 12 months. […] Peyronies disease surgery options include: […] Shortening the unaffected side of your penis. […] Making the side of your penis on the inside of the curve longer. […] Penile implant. […] It depends on the severity of your condition and what type of treatment you receive. A healthcare provider will give you an estimate on when you can expect to feel better after treatment.

• #2 Medical Management of Peyronie’s Disease: Review of the Clinical Evidence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6780399/

  None of the current guidelines recommend topical therapy in Peyronies disease. […] A great number of medical treatments have been suggested and utilized in PD. Evidence from randomized controlled trial with regards to improvement in curvature exists for intralesional (with CCH and interferon -2b) and traction therapy. Oral therapy has not proven to be effective and due to potential side-effects and costs, is not currently recommended.

• #2 Peyronie’s Disease: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/10044-peyronies-disease

  Peyronies disease treatment options include: […] Traction therapy […] These therapies utilize an external device, such as a vacuum erection device or traction device (RestoreX), to gently stretch your penis and sometimes even bend it in the opposite direction of the curve. It encourages the scar tissue to break down and can: […] Improve curvature. […] Restore lost length. […] Increase erection hardness. […] Most people need to use the traction therapy device for several months to see improvement. […] There are generally no long-term side effects of properly using a traction therapy device. […] A healthcare provider may recommend medications you take by mouth (oral medications) or inject into your penis. Providers usually recommend medications if you have acute Peyronies disease or if you’re not sure if you want surgery. However, they rarely result in a straight penis.

• #2 Medical Management of Peyronie’s Disease: Review of the Clinical Evidence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6780399/

  A single randomized controlled study assessing hyaluronic acid has been reported. […] Intralesional steroids have not been shown to have an advantage over a placebo in randomized studies. […] A network meta-analysis of eight randomized controlled studies suggested that in regards to penile curvature, CCH and interferon -2b are associated with better outcomes than verapamil or hyaluronic acid. […] In summary, mechanical therapy is now supported by randomized controlled trials in the acute and stable phase of Peyronies disease to improve penile curvature. […] The use of extracorporeal shock wave therapy (ESWT) for the reduction of penile curvature or plaque size is not recommended. […] To date, no oral treatment has proven to be effective in improving penile curvature in patients with stable disease.

• #2 Treatment of Peyronie’s Disease < Sexual and Reproductive Medicine Blog

  https://medicine.yale.edu/lab/urology-mens-health-blog/2022/mar/

  Intralesional verapamil is one of the treatment options available for peyronies disease. It is not FDA approved for this indication and therefore is considered an off label treatment. Published data suggests that 50% of patients will have some improvement in penile curvature and 50% will not. If curvature improvement is present usually modest, maybe 10-15 degree improvement. Occasionally, significant improvement can occur. It is a series of six injections which occur every two weeks. Side effects are uncommon and include mild swelling and bruising to the penis. Theres no limitation sexually in between treatments. […] Collagenase or Xiaflex is FDA approved for patients with peyronies disease and curvature between a30-90 degrees angle. The published data suggests that 70% of men will have a combination of improvement of patient bother and/or improvement in curvature after four treatments cycles. Each cycle consists of two collagenase injections separated by 3- 7days. This is followed by penile modeling or bending of the penis (done 3x daily for 30 seconds)- every day starting 2 days after the second treatment. This cycle is repeated 4 times. There should be no sexual activity for 4 weeks after the second treatment in the cycle.

• #2 Medical Management of Peyronie’s Disease: Review of the Clinical Evidence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6780399/

  The present article reviews the clinical evidence for the medical management of Peyronies disease, including intralesional therapy, mechanical therapy, ESWT, oral therapy, and topical therapy. […] A recent systematic review concluded that the currently available clinical evidence from randomized trials only supports collagenase clostridium histolyticum (CCH) and IFN-2b as being capable of improving penile curvature in patients with Peyronies disease. […] The best evidence of improvement of curvature in Peyronies disease exists for collagenase clostridium histolyticum. […] Intralesional interferon -2b has been shown to be superior to a placebo in improving penile curvature and plaque size in two small placebo-controlled studies. […] Currently, there is no good-quality evidence from randomized studies to support the use of verapamil.

• #2 Peyronie’s Disease Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/peyronies-disease-guideline

  10. Clinicians may administer intralesional interferon -2b in patients with Peyronie’s disease. (Moderate Recommendation; Evidence Strength Grade C) […] 12. Clinicians may offer intralesional verapamil for the treatment of patients with Peyronie’s disease. (Conditional Recommendation; Evidence Strength Grade C) […] 14. Clinicians should not use extracorporeal shock wave therapy (ESWT) for the reduction of penile curvature or plaque size. (Moderate Recommendation; Evidence Strength Grade B) […] 15. Clinicians may offer extracorporeal shock wave therapy (ESWT) to improve penile pain. (Conditional Recommendation; Evidence Strength Grade B) […] 18. Clinicians may offer tunical plication surgery to patients whose rigidity is adequate for coitus (with or without pharmacotherapy and/or vacuum device therapy) to improve penile curvature. (Moderate Recommendation; Evidence Strength Grade C)

• #2 Peyronie disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/peyronies-disease/diagnosis-treatment/drc-20353473

  Traction therapy is recommended in the early phase of Peyronie disease. It’s the only treatment shown to improve penis length. Traction therapy also may be used in the chronic phase of the disease, combined with other treatments or after surgery for a better outcome. […] Your doctor might suggest surgery if the curve or bend of your penis is severe, bothers you a lot or prevents you from having sex. […] Common types of surgery for Peyronie disease include: […] The type of surgery used depends on your condition. […] Before you get surgery for Peyronie disease, ask your surgeon about the risks. […] Researchers continue to explore other treatments for Peyronie disease. Evidence is limited on how well they work and what their side effects might be. Examples include use of intense sound waves to break up scar tissue, stem cells, platelet-rich plasma and radiation therapy. Currently, these therapies are considered experimental.

• #2 Treatment of Peyronie’s Disease < Sexual and Reproductive Medicine Blog

  https://medicine.yale.edu/lab/urology-mens-health-blog/2022/mar/

  This surgical procedure allows for improvement in curvature to the penis. It is usually performed as an outpatient procedure and involves putting stitches on the opposite side of the penis that is curved. It does not remove the scar tissue. In the experience of the Yale Urology, we can correct approximately 65 curvature to the penis with this therapy. Post operatively, no sexual activity or stimulation is allowed for approximately six weeks. […] This operation is usually recommended in patients who have over a 70 curvature to the penis. It is recommended that this be performed by a urologist who has expertise in reconstructive surgery or sexual medicine. It is an outpatient procedure and sexual activity can be resumed approximately six to eight weeks after surgery. […] For patients with a combination of non resolvable erectile dysfunction and penile curvature from peyronies disease, a penile prosthesis is the recommended treatment of choice. […] The Yale Urology team offers all these treatments in men who have intact erectile function and peyronies disease. We have extensive experience with all these treatment options.

• #2 Early treatment for Peyronie’s disease – Mayo Clinic Health System

  https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/early-treatment-for-peyronies-disease

  Injection therapy Some medications can be injected directly in the penile scar tissue. One example is collagenase, the only medication that the Food and Drug Administration has approved for the disease. This medication breaks down the buildup of collagen. Verapamil and interferon are other injection options. They disrupt the production of fibrous tissues and are shown to reduce pain. […] While penile traction and injection therapy are a part of the treatment plan during the chronic phase, surgery is another option and is the most definitive treatment. Surgery, however, is not recommended until symptoms have stabilized for at least three months. […] Some common surgical options include: Suturing the unaffected side (penile plication) A surgical procedure can be performed on the side of the penis with no scar tissue.

• #2 Penile Curvature (Peyronie’s Disease) – NIDDK

  https://www.niddk.nih.gov/health-information/urologic-diseases/penile-curvature-peyronies-disease

  A urologist may recommend surgery to remove plaque or help straighten the penis during an erection. […] Medical experts recommend you dont have surgery until your plaque and penis curving stabilize. […] In this surgery, your urologist will remove the plaque and replace it with a patch of tissue that was taken from another part of your body, such as skin or a vein from your leg; grown in a laboratory; or from organ donors. […] In plication surgery, your urologist will remove or pinch a piece of the tunica albuginea from the side of the penis opposite the plaque to help straighten the penis. […] Penile implants may be considered if a man has both Peyronies disease and ED.

• #2 Early treatment for Peyronie’s disease – Mayo Clinic Health System

  https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/early-treatment-for-peyronies-disease

  Grafting (plaque incision and grafting) During this procedure, the scar tissue is cut, and a piece of tissue called a graft is sewn into place to cover the gaps. […] Penile implants Often, men with Peyronie’s disease also are affected by erectile dysfunction. The best treatment to correct both conditions is placement of an inflatable penile prosthesis.

• #2 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20250402/Understanding-the-phases-and-treatment-options-for-Peyroniee28099s-disease.aspx

  Surgical intervention is reserved for stable disease and is highly individualized, depending on the severity of curvature and the presence of erectile dysfunction. Techniques such as tunical shortening or lengthening, plaque incision or excision with grafting, and inflatable penile prosthesis placement are commonly employed, each with its own set of benefits and risks. […] Future directions in PD management are focused on improving diagnostic accuracy, understanding the underlying biological mechanisms, and developing targeted therapies. Advances in imaging, such as contrast-enhanced MRI and nuclear scintigraphy, may help better distinguish between active and stable disease. Regenerative therapies, including stem cells and platelet-rich plasma, hold promise for addressing both fibrosis and erectile dysfunction. Additionally, ongoing clinical trials are exploring novel treatments, including combination therapies and new surgical techniques, which may further refine the management of PD.

• #2 Peyronie’s Disease: Non-Surgical Novel Treatment Modalities | RRU

  https://www.dovepress.com/peyronies-disease-an-outcomes-based-guide-to-non-surgical-and-novel-tr-peer-reviewed-fulltext-article-RRU

  One of the mainstays of conservative PD treatment is penile traction therapy (PTT). […] Across the majority of PTT trials and regardless of the type of device utilized, PTT monotherapy was not found to have any significant adverse effects. […] Intralesional collagenase clostridium histolyticum (CCH; Xiaflex) remains the only Food and Drug Administration (FDA) approved intralesional therapy for PD. […] Overall, at present, there is conflicting data on how certain clinical factors such as duration of PD, initial degree of curvature, and plaque location impact outcomes of CCH therapy. […] More recently, low-intensity extracorporeal shockwave therapy (LiESWT) has gained attention as a non-invasive treatment modality for a variety of pathologies. […] At present, the utilization of PRP for the treatment of PD remains an area of limited understanding. […] At present, monotherapy with oral antioxidant medications has proven to be minimally efficacious in the treatment of acute phase PD, and as such, their use is not supported by the AUA guidelines. […] The treatment of PD is constantly evolving.

• #2 What Causes Peyronie’s Disease and Is it Treatable? | University of Utah Health

  https://healthcare.utah.edu/the-scope/health-library/all/2019/08/what-causes-peyronies-disease-and-it-treatable

  With traction therapy, this is something that men can do at home. […] I actually don’t use oral therapies very much, and we don’t use them very much in our practice here in Utah because our professional society, the American Urological Association, in 2015, came out with guidance that they don’t really work. […] Injection therapies are drugs that we inject directly into this scar tissue that can either help dissolve it or prevent more of it from forming. […] Surgery, there are numerous surgical options. […] You need to talk to your patient and figure out how much they want treatment, and how quickly and, you know, ultimately how much time they’re willing to devote to treatment, and how aggressive they want to get will help determine what they end up doing. […] I would encourage guys to come in, at least have a discussion because that way you can know what the evidence is, one way or another, and make your decision based on a level playing field. […] If a man has not seen a male sexual dysfunction specialist, so somebody who is specifically trained in managing these types of conditions, and there are a handful of us across the country, then they should seek someone out like that.

• #2 Peyronie’s Disease: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/10044-peyronies-disease

  Some mild cases of Peyronies disease go away without treatment. But it’s rare for severe penile curvature or plaques to go away on their own without treatment. […] Your body is unique, and how it responds to Peyronies disease may be different from others. In mild cases, your symptoms may improve without treatment. In more severe cases, your symptoms may stay the same or gradually get worse.

• #2 Nonsurgical treatment shows advantages in Peyronie’s disease | Wolters Kluwer

  https://www.wolterskluwer.com/en/news/nonsurgical-treatment-shows-advantages-in-peyronies-disease

  For men with Peyronie’s disease (PD), nonsurgical treatment including injections of collagenase clostridium histolyticum (CCH) produces high satisfaction with sexual outcomes with fewer adverse events compared to surgery, reports a clinical trial in the October issue of The Journal of Urology, an official journal of the American Urological Association (AUA). […] In 2014, the US Food and Drug Administration approved CCH as a nonsurgical alternative. Treatment includes injections of CCH, with the aim of breaking down the plaque tissue causing the penile curvature. […] Nonsurgical treatment included CCH injections, followed by the use of a traction device (RestoreX) to help stretch and shape the penis plus the oral medication sildenafil. […] After three months, 50% of men assigned to CCH reported being „very satisfied” with their outcomes, compared to 21% in the surgery group. […] Although surgery produces greater improvement in penile curvature, sexual function and overall patient satisfaction appear higher with CCH injection therapy.

• #2 What Causes Peyronie’s Disease and Is it Treatable? | University of Utah Health

  https://healthcare.utah.edu/the-scope/health-library/all/2019/08/what-causes-peyronies-disease-and-it-treatable

  Peyronie’s disease is an extremely treatable condition, but you need to see a doctor. […] Peyronie’s disease is a very treatable condition, but you have to seek help in order to get that treatment. […] One of the big things with Peyronie’s disease that brings guys out of the eaves really is knowing that it’s highly treatable and knowing that a lot of other men actually have it, and that they really shouldn’t be ashamed to see somebody about it because there are a lot of us that can actually treat it. […] Ultimately, you need to seek treatment or the best time to seek treatment is when your curvature is no longer getting worse because that’s what’s considered the stable phase of the condition. […] There are four different categories [of treatment]: traction therapy, oral therapies, injection therapies, and surgery.

• #2 Advances in Treatment for Peyronie’s Disease – Mass General Advances in Motion

  https://advances.massgeneral.org/urology/article.aspx?id=1077

  Dr. Nehra explains that multiple surgical approaches to correct advanced, chronic Peyronie’s disease have been refined and validated over the years. […] Surgical procedures straighten the shaft to correct curvature. […] „People need to know Peyronie’s disease is entirely treatable, but that early care is essential,” Dr. Nehra says. „Our goal is to preserve nerve and penile function, eliminate pain and optimize sexual function.”

• #3

  https://peyronies-disease.xiaflex.com/patient/

  When paired with daily penile exercises, XIAFLEX has been proven to help reduce erectile curvature in appropriate men with PD.* […] XIAFLEX for the treatment of Peyronies disease is only available through a restricted program called the XIAFLEX Risk Evaluation and Mitigation Strategy (REMS) Program. […] Find a Urology Specialist trained to use XIAFLEX near you who can diagnose PD and decide if treatment with XIAFLEX may help.

• #3 Get Peyronie’s Disease Treatment | Cleveland Clinic

  https://my.clevelandclinic.org/services/peyronies-disease-treatment

  Penile plication: During penile plication, we cut out or fold tissue on the curved side of your penis and secure it with stitches. Tightening the skin helps straighten your penis. The procedure can make the penis shorter, but its less likely than grafting to cause ED. […] If you have a curved penis and ED, your provider might recommend surgical penile implants (penile prostheses). Most implants are inflatable pumps that you can control when youre ready to have sex. In some cases, we do penile grafting or plication at the same time as the implantation procedure.

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