No tablet treatment has been shown to reverse penile curvature, but some medications can be of use in Peyronie’s disease.
Vitamin E or Pentoxyifylline can improve the inflammatory pain during the acute (inflammatory) phase, which is sually in the first 6 months.
The use of Potaba® (Para-amino-benzoate) has been to shown to limit worsening of the curvature, but requires 4 times a day treatment, and it can cause gastro-intestinal side-effects.
There is emerging evidence for the benefit of vacuum therapy device exercises, and this involves a daily stretching exercise for 5-10 minutes for 3-4 months. A trial is currently underway to study this in more detail, but initial data suggests that half of men achieve a sustained improvement in penile curvature.
A significant proportion of men with Peyronie’s disease require surgery to correct their deformity and restore sexual function. Mr Rees performs over 50 procedures a year for Peyronie’s disease.
There are 3 broad types of operations for Peyronie’s disease:
Nesbit (or Yachia / Lemberger / Essed plication) – these procedures are aimed at shortening the long (healthy) side of the penis – they are simple, have a low complication rate and high success rate (less than 5% require further treatment).
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Incision and Grafting (Lue) procedure: this is a procedure is aimed at cutting into the scar tissue to create a gap, and inserting a graft (such as a piece of vein, or bovine collagen) into that gap. It has the potential advantage of causing less penile shortening, but due to the complexity carries a 30% complication rate in the medium term – such as erectile dysfunction recurrent scar tissue etc.
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Penile prostheses: Where there is a combination of penile curvature and erectile dysfunction, often the best and most durable solution is to insert a penile prosthesis or implant.
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Unfortunately collagenase injection therapy is no longer available in Europe
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