services - Peyronies Disease
Peyronies disease may result in penile curvature and other changes to the shape of a man’s penis. There are several different treatment options available. Choosing a personalized treatment plan begins with a detailed evaluation and examination.
What is Peyronies Disease?
Peyronies disease is characterized as development of a fibrotic plaque in a man’s penis that leads to numerous potential symptoms including: penile curvature, deformity, shortening, pain and erectile dysfunction. Peyronies can be found in up to 8.9% of men, most often occurring among men older than 40, but may occur in men of all ages. Peyronies is different than congenital penile curvature, as the latter is present since the time of birth, where Peyronies is acquired later in life. Some men will have penile pain associated with the onset of symptoms. Curvatures can range in severity from a slight bend to significant curves greater than 90 degrees.Peyronies disease can be very distressing to both the man and their partner. In fact, among men completing depression questionnaires, nearly 50% meet the threshold for clinically meaningful depression, and just over 50% of men report relationship problems as a result of this disease. It is important for these men to know that specialists exist that are experts in Peyronies disease and are encouraged to connect with their physicians.
What are Treatment Options?
Many agents have been tested in Peyronies disease. These include oral therapies, penile injections and surgical procedures.
- Intralesional Therapies. Injection of medications into the Peyronies plaque in the penis is considered a first-line approach for a large proportion of men. Injections of medication are often combined with penile modelling or traction devices that mechanically stretch the plaque.
- Mechanical Techniques. Penile modeling and traction techniques may provide some benefit to treatment alone or in combination with above intralesional therapies. These techniques are thought to stretch and lengthen the shortened Peyronies plaques.
- Surgical Therapies. For men that are not candidates for other forms of therapy, and are both psychologically and functionally bothered by their Peyronies Disease, surgery may be an option. This may include different techniques depending upon the nature of the curve, deformity and baseline erectile function. It is best to discuss these options with a Peyronies expert.
- Other Therapies:
- Shockwave Therapy. Extra-corporeal shockwave therapy (ESWL) is a technology used in many conditions. Its use in Peyronies has shown a benefit in pain reduction, but has not consistently shown improvement in penile curvature.
- Oral Therapies. The Canadian Urologic Association has put forth a limited number of oral therapies, whereas the American Urologic Association not put forth any recommendations due to a lack of available evidence. It is accepted that use of oral therapies should not delay other more definitive therapies for men with Peyronies. However, use of oral agents to help erectile function among men with Peyronies and erectile dysfunction can certainly be of benefit. Furthermore, non-steroidal anti-inflammatory medications may be used to help reduce penile pain among those men affected.
- Botox Injections. Data is limited at the present time. More studies will be required to determine if it is a suitable therapy for Peyronies disease.
- Stem Cell Therapy. Stem cell therapy is under investigation and studies are presently lacking that objectively demonstrate robust and reproducibly favorable results.
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