Top

Current Urology Reports

Published in:

01-02-2021 | Conservative Therapy | Men's Health (R Carrion, Section Editor)

Conservative Therapy for Peyronie’s Disease: a Contemporary Review of the Literature

Authors: Ayad Yousif, Caleb Natale, Wayne J. G. Hellstrom

Published in: Current Urology Reports | Issue 2/2021

Abstract

Purpose of Review

To analyze the literature on current conservative treatment options for Peyronie’s disease (PD).

Recent Findings

Conservative therapy with intralesional collagenase clostridium histolyticum (CCH) is safe and efficacious in either the acute or chronic phases of PD. Combination treatment with penile traction therapy (PTT) can produce even better results. While most PTT devices require extended periods of therapy up to 8 h per day, the RestoreX® device can be effective at 30–90 min per day.

Summary

A variety of conservative therapies are available for treatment of PD. The available literature does not reveal any treatment benefit of oral therapies. Intralesional therapy is the mainstay conservative treatment of PD. Intralesional CCH therapy is the first Food and Drug Administration-approved intralesional therapy and represents the authors’ preference for medical therapy. The most effective conservative management of PD likely requires a combination of therapies.

Devine CJ Jr, et al. Proposal: trauma as the cause of the Peyronie’s lesion. J Urol. 1997;157:285–90.PubMed

Sharma KL, Alom M, Trost L. The etiology of Peyronie’s disease: pathogenesis and genetic contributions. Sex Med Rev. 2020;8(2):314–23. https://doi.org/10.1016/j.sxmr.2019.06.004.CrossRefPubMed

Dibenedetti DB, Nguyen D, Zografos L, Ziemiecki R, Zhou X. A population-based study of Peyronie’s disease: prevalence and treatment patterns in the United States. Ther Adv Urol. 2011;2011:282503–9. https://doi.org/10.1155/2011/282503.CrossRef

Schwarzer U, Sommer F, Klotz T, Braun M, Reifenrath B, Engelmann U. The prevalence of Peyronie’s disease: results of a large survey. BJU Int. 2001;88(7):727–30.PubMed

Chung E, Gillman M, Rushton D, Love C, Katz D. Prevalence of penile curvature: a population-based cross-sectional study in metropolitan and rural cities in Australia. BJU Int. 2018;122(Suppl 5):42–9.PubMed

Hussein AA, Alwaal A, Lue TF. All about Peyronie’s disease. Asian J Urol. 2015;2(2):70–8. https://doi.org/10.1016/j.ajur.2015.04.019.CrossRefPubMedPubMedCentral

• Nehra A, Alterowitz R, Culkin DJ, et al. Peyronie’s disease: AUA guideline. J Urol. 2015;194(3):745–53. https://doi.org/10.1016/j.juro.2015.05.098. A systematic review of the literature was performed to create guidelines pertinent to the diagnosis and treatment of Peyronie’s disease. AUA recommendations are based on consensus of scientific evidence.CrossRefPubMedPubMedCentral

• EAU Guidelines. Edn. presented at the EAU Annual Congress Amsterdam. 2020. ISBN 978–94–92671-07-3. A systematic review of the literature was performed to create guidelines pertinent to the diagnosis and treatment of Peyronie’s disease. EAU recommendations are based on consensus of scientific evidence.

Chung E, Ralph D, Kagioglu A, Garaffa G, Shamsodini A, Bivalacqua T, et al. Evidence-based management guidelines on Peyronie’s disease. J Sex Med. 2016;13(6):905–23. https://doi.org/10.1016/j.jsxm.2016.04.062.CrossRefPubMed

10.

Brimley SC, Yafi FA, Greenberg J, Hellstrom WJG, Tue Nguyen HM, Hatzichristodoulou G. Review of management options for active-phase Peyronie’s disease. Sex Med Rev. 2019;7(2):329–37. https://doi.org/10.1016/j.sxmr.2018.09.007.CrossRefPubMed

11.

Zarafonetis CJ, Horrax TM. Treatment of Peyronie’s disease with potassium para-aminobenzoate (potaba). J Urol. 1959;81:770–2.PubMed

12.

Weidner W, Hauck EW, Schnitker J, et al. Potassium paraaminobenzoate (POTABA) in the treatment of Peyronie’s disease: a prospective, placebo-controlled, randomized study. Eur Urol. 2005;47:530–5.PubMed

13.

Park TY, Jeong HG, Park JJ, Chae JY, Kim JW, Oh MM, et al. The efficacy of medical treatment of Peyronie’s disease: potassium para-aminobenzoate monotherapy vs. combination therapy with tamoxifen, L-carnitine, and phosphodiesterase type 5 inhibitor. World J Mens Health. 2016;34(1):40–6.PubMedPubMedCentral

14.

Al Attar L, Kilgore W. Rare incidence of acute liver injury with potassium para-aminobenzoate introduction. Case Rep Gastroenterol. 2018;12(2):230–3 Published 2018 May 31.PubMedPubMedCentral

15.

Evans HM, Bishop KS. On the existence of a hitherto unrecognized dietary factor essential for reproduction. Science. 1922;56(1458):650–1.PubMed

16.

Sikka SC, Hellstrom WJ. Role of oxidative stress and antioxidants in Peyronie’s disease. Int J Impot Res. 2002;14(5):353–60.PubMed

17.

Scott WW, Scardino PL. A new concept in the treatment of Peyronie’s disease. South Med J. 1948;41:173–7.PubMed

18.

Safarinejad MR, Hosseini SY, Kolahi AA. Comparison of vitamin E and propionyl-L-carnitine, separately or in combination, in patients with early chronic Peyronie’s disease: a double-blind, placebo controlled, randomized study. J Urol. 2007;178(4 Pt 1):1398–403 discussion 1403.PubMed

19.

Claro JA, Passerotti CC, Figueiredo Neto AC, Nardozza A Jr, Ortiz V, Srougi M. An alternative non-invasive treatment for Peyronie’s disease. Int Braz J Urol. 2004;30(3):199–204.PubMed

20.

Paulis G, Brancato T, D’Ascenzo R, de Giorgio G, Nupieri P, Orsolini G, et al. Efficacy of vitamin E in the conservative treatment of Peyronie’s disease: legend or reality? A controlled study of 70 cases. Andrology. 2013;1(1):120–8.PubMed

21.

Paulis G, Paulis A, Romano G, Barletta D, Fabiani A. Rationale of combination therapy with antioxidants in medical management of Peyronie’s disease: results of clinical application. Res Rep Urol. 2017;9:129–39. Published 2017 Jul 20. https://doi.org/10.2147/RRU.S141748.CrossRefPubMedPubMedCentral

22.

Porst H, Burri A, European Society for Sexual Medicine (ESSM) Educational Committee. Current strategies in the management of Peyronie’s disease (PD)-results of a survey of 401 sexual medicine experts across Europe [published correction appears in J Sex Med. 2019 Sep;16(9):1486]. J Sex Med. 2019;16(6):901–8.PubMed

23.

Shindel AW, Lin G, Ning H, Banie L, Huang YC, Liu G, et al. Pentoxifylline attenuates transforming growth factor-β1-stimulated collagen deposition and elastogenesis in human tunica albuginea-derived fibroblasts part 1: impact on extracellular matrix. J Sex Med. 2010;7(6):2077–85.PubMedPubMedCentral

24.

Safarinejad MR, Asgari MA, Hosseini SY, Dadkhah F. A double-blind placebo-controlled study of the efficacy and safety of pentoxifylline in early chronic Peyronie’s disease [retracted in: Safarinejad MR, Asgari MA, Hosseini SY, Dadkhah F. BJU Int. 2015 Mar;115(3):E10]. BJU Int. 2010;106(2):240–8.PubMed

25.

Ibrahim A, Gazzard L, Alharbi M, Rompré-Brodeur A, Aube M, Carrier S. Evaluation of oral pentoxifylline, colchicine, and penile traction for the management of Peyronie’s disease. Sex Med. 2019;7(4):459–63.PubMedPubMedCentral

26.

Paulis G, Barletta D, Turchi P, et al. Efficacy and safety evaluation of pentoxifylline associated with other antioxidants in medical treatment of Peyronie’s disease: a case-control study. Res Rep Urol. 2015;8:1–10 Published 2015 Dec 31.PubMedPubMedCentral

27.

Gallo L, Sarnacchiaro P. Ten-year experience with multimodal treatment for acute phase Peyronie’s disease: a real life clinical report. Diez años de experiencia con el tratamiento multimodal de la fase aguda de la enfermedad de Peyronie: reporte médico de la vida real. Actas Urol Esp. 2019;43(4):182–9. https://doi.org/10.1016/j.acuro.2018.08.005.CrossRefPubMed

28.

Valente EG, Vernet D, Ferrini MG, Qian A, Rajfer J, Gonzalez-Cadavid NF. L-arginine and phosphodiesterase (PDE) inhibitors counteract fibrosis in the Peyronie’s fibrotic plaque and related fibroblast cultures. Nitric Oxide. 2003;9(4):229–44.PubMed

29.

Chung E, Deyoung L, Brock GB. The role of PDE5 inhibitors in penile septal scar remodeling: assessment of clinical and radiological outcomes. J Sex Med. 2011;8(5):1472–7.PubMed

30.

Ozturk U, Yesil S, Goktug HN, et al. Effects of sildenafil treatment on patients with Peyronie’s disease and erectile dysfunction. Ir J Med Sci. 2014;183(3):449–53.PubMed

31.

Ilg MM, Mateus M, Stebbeds WJ, Milenkovic U, Christopher N, Muneer A, et al. Antifibrotic synergy between phosphodiesterase type 5 inhibitors and selective oestrogen receptor modulators in Peyronie’s disease models. Eur Urol. 2019;75(2):329–40.PubMed

32.

Farrell MR, Ziegelmann MJ, Levine LA. Minimally invasive therapies for Peyronie’s disease: the current state of the art. Transl Androl Urol. 2020;9(Suppl 2):S269–83. https://doi.org/10.21037/tau.2019.08.06.CrossRefPubMedPubMedCentral

33.

Cocci A, Cito G, Urzì D, Minervini A, di Maida F, Sessa F, et al. Sildenafil 25 mg ODT + collagenase Clostridium hystoliticum vs collagenase Clostridium hystoliticum alone for the management of Peyronie’s disease: a matched-pair comparison analysis. J Sex Med. 2018;15(10):1472–7. https://doi.org/10.1016/j.jsxm.2018.08.012.CrossRefPubMed

34.

Chung E. Peyronie’s disease and low intensity shock wave therapy: clinical outcomes and patient satisfaction rate in an open-label single arm prospective study in Australian men. Korean J Urol. 2015;56(11):775–80.PubMedPubMedCentral

35.

Martin DJ, Badwan K, Parker M, Mulhall JP. Transdermal application of verapamil gel to the penile shaft fails to infiltrate the tunica albuginea. J Urol. 2002;168(6):2483–5.PubMed

36.

Anderson MS, Shankey TV, Lubrano T, Mulhall JP. Inhibition of Peyronie’s plaque fibroblast proliferation by biologic agents. Int J Impot Res. 2000;12(Suppl 3):S25–31.PubMed

37.

Rehman J, Benet A, Melman A. Use of intralesional verapamil to dissolve Peyronie’s disease plaque: a long-term single-blind study. Urology. 1998;51(4):620–6.PubMed

38.

Fitch WP 3rd, Easterling WJ, Talbert RL, Bordovsky MJ, Mosier M. Topical verapamil HCl, topical trifluoperazine, and topical magnesium sulfate for the treatment of Peyronie’s disease-a placebo-controlled pilot study. J Sex Med. 2007;4(2):477–84.PubMed

39.

Qiu XW, Wang JH, Fang XW, Gong ZY, Li ZQ, Yi ZH. Di Yi Jun Yi Da Xue Xue Bao. 2005;25(4):407–10.PubMed

40.

Twidwell J, Levine L. Topical treatment for acute phase Peyronie’s disease utilizing a new gel, H-100: a randomized, prospective, placebo-controlled pilot study [published correction appears in Int J Impot Res. 2020 Jun 2]. Int J Impot Res. 2016;28(2):41–5. https://doi.org/10.1038/ijir.2015.22.CrossRefPubMed

41.

Di Stasi SM, Giannantoni A, Stephen RL, et al. A prospective, randomized study using transdermal electromotive administration of verapamil and dexamethasone for Peyronie’s disease. J Urol. 2004;171(4):1605–8.PubMed

42.

Greenfield JM, Shah SJ, Levine LA. Verapamil versus saline in electromotive drug administration for Peyronie’s disease: a double-blind, placebo controlled trial. J Urol. 2007;177(3):972–5.PubMed

43.

Aliperti LA, Mehta A. Peyronie’s disease: intralesional therapy and surgical intervention. Curr Urol Rep. 2016;17(9):60. https://doi.org/10.1007/s11934-016-0622-2.CrossRefPubMed

44.

Sukumar S, Pijush DB, Brandes S. Impact of the advent of collagenase Clostridium histolyticum on the surgical management of Peyronie’s disease: a population-based analysis. J Sex Med. 2020;17(1):111–6. https://doi.org/10.1016/j.jsxm.2019.09.022.CrossRefPubMed

45.

Levine LA, Merrick PF, Lee RC. Intralesional verapamil injection for the treatment of Peyronie’s disease. J Urol. 1994;151:1522–4.PubMed

46.

Levine LA. Treatment of Peyronie’s disease with intralesional verapamil injection. J Urol. 1997;158:1395–9.PubMed

47.

Levine LA, Goldman KE, Greenfield JM. Experience with intraplaque injection of verapamil for Peyronie’s disease. J Urol. 2002;168:621–5; discussion 625–626.PubMed

48.

Shirazi M, Haghpanah AR, Badiee M, Afrasiabi MA, Haghpanah S. Effect of intralesional verapamil for treatment of Peyronie’s disease: a randomized single-blind, placebo-controlled study. Int Urol Nephrol. 2009;41:467–71.PubMed

49.

Favilla V, Russo GI, Zucchi A, Siracusa G, Privitera S, Cimino S, et al. Evaluation of intralesional injection of hyaluronic acid compared with verapamil in Peyronie’s disease: preliminary results from a prospective, double-blinded, randomized study. Andrology. 2017;5(4):771–5.PubMed

50.

•• Russo GI, Milenkovic U, Hellstrom W, Levine LA, Ralph D, Albersen M. Clinical efficacy of injection and mechanical therapy for Peyronie’s disease: a systematic review of the literature. Eur Urol. 2018;74(6):767–81. https://doi.org/10.1016/j.eururo.2018.07.005. This systematic review includes evidence synthesized from available literature. The study reported that there is sufficient evidence to suggest that CCH and IFNα-2b injection therapy have a clinically significant effect on improving penile curvature and conserving penile length. There was no sufficient evidence to support the use of other injection and mechanical treatments for PD.CrossRefPubMed

51.

Duncan MR, Berman B, Nseyo UO. Regulation of the proliferation and biosynthetic activities of cultured human Peyronie’s disease fibroblasts by interferons-alpha, -beta and -gamma. Scand J Urol Nephrol. 1991;25:89–94.PubMed

52.

Hellstrom WJG, et al. Single-blind, multicenter, placebo controlled, parallel study to assess the safety and efficacy of intralesional interferon α-2b for minimally invasive treatment for Peyronie’s disease. J Urol. 2006;176(1):394–8.PubMed

53.

Trost LW, et al. Outcomes of Intralesional Interferon-α2B for the Treatment of Peyronie Disease. J Urol. 2013;190(6):2194–9.PubMed

54.

Stewart CA, et al. Intralesional injection of interferon-α2b improves penile curvature in men with Peyronie’s disease independent of plaque location. J Urol. 2015;194(6):1704–7.PubMed

55.

Natale C, McLellan DM, Yousif A, Hellstrom WJG. Review of intralesional collagenase Clostridium histolyticum injection therapy and related combination therapies in the treatment of Peyronie’s disease (an update) [published online ahead of print, 2020 Mar 18]. Sex Med Rev. 2020;S2050–0521(20):30009–3. https://doi.org/10.1016/j.sxmr.2020.01.005.CrossRef

56.

Gelbard M, Goldstein I, Hellstrom WJ, et al. Clinical efficacy, safety and tolerability of collagenase Clostridium histolyticum for the treatment of peyronie disease in 2 large double-blind, randomized, placebo-controlled phase 3 studies. J Urol. 2013;190:199–207.PubMed

57.

Levine LA, Cuzin B, Mark S, Gelbard MK, Jones NA, Liu G, et al. Clinical safety and effectiveness of collagenase Clostridium histolyticum injection in patients with Peyronie’s disease: a phase 3 open-label study. J Sex Med. 2015;12:248–58.PubMed

58.

• Goldstein I, et al. Long-term safety and curvature deformity characterization in patients previously treated with collagenase Clostridium histolyticum for Peyronie’s disease. J Urol. 2020;203(6):1191–7. This phase-4 study included men previously enrolled in either the IMPRESS trials or the open-label studies of CCH. While 280 patients were included in the study, only 204 completed the study. Of these, 180 showed additional penile curvature improvement at 5-year follow-up. Patients also showed improvement in PDQ bother domain mean score. This study reports sustained long-term improvement in penile curvature in patients treated with CCH therapy at 5-year follow-up without further CCH treatment.PubMed

59.

Nguyen HMT, Anaissie J, DeLay KJ, et al. Safety and efficacy of collagenase Clostridium histolyticum in the treatment of acute-phase Peyronie’s disease. J Sex Med. 2017;14:1220–5.PubMed

60.

•• Hellstrom WJG, et al. Intralesional collagenase Clostridium histolyticum causes meaningful improvement in men with Peyronie’s disease: results of a multi-institutional analysis. J Urol. 2019;201(4):777–82. First large, multi-institutional study which occurred at institutions where the IMPRESS trial was instituted for the routine treatment of PD. This study reported no difference in response to CCH therapy in the acute vs. stable phases of PD. This study also illustrated that number of cycles was predictive of curvature improvement.PubMed

61.

Alom M, et al. Safety and efficacy of collagenase Clostridium histolyticum in Peyronie’s disease men with ventral curvatures. Urology. 2019;129:119–25.PubMed

62.

Cocci A, Di Maida F, Russo GI, et al. How atypical penile curvature influence clinical outcomes in patients with Peyronie’s disease receiving collagenase Clostridium histolyticum therapy? World J Mens Health. 2020;38(1):78–84. https://doi.org/10.5534/wjmh.190026.CrossRefPubMed

63.

Masterson TA, Rezk A, Ramasamy R. Characteristics predictive of response to collagenase Clostridium histolyticum for Peyronie’s disease: a review of the literature. World J Urol. 2020;38(2):279–85. https://doi.org/10.1007/s00345-019-02850-3.CrossRefPubMed

64.

Gelbard MK, Walsh R, Kaufman JJ. Collagenase for Peyronie’s disease experimental studies. Urol Res. 1982;10:135–40.PubMed

65.

• Abdel Raheem A, Capece M, Kalejaiye O, et al. Safety and effectiveness of collagenase Clostridium histolyticum (CCH) (Xiapex®) in the treatment of Peyronie’s disease using a new modified shortened protocol. BJU Int. 2017;120(5):717–23. In this prospective study of 53 subjects at a single center, patients underwent a shortened, nonrandomized protocol of 3 CCH injections at 4-week intervals in combination with manual modeling, stretching, and vacuum device on a daily basis. Reported results were similar to those of the IMPRESS trials, indicating that a shortened protocol may be appropriate in some patients.

66.

Fernández-Pascual E, González-García FJ, Angulo J, Cerezo E, Quintana LM, Turo J, et al. Optimizing collagenase Clostridium histolyticum therapy for Peyronie’s disease using a novel approach with percutaneous needle tunnelling. BJU Int. 2019;124(6):1055–62. https://doi.org/10.1111/bju.14784.CrossRefPubMed

67.

García-Gómez B, García-Rojo E, Alonso-Isa M, et al. Treatment of Peyronie’s disease with combination of Clostridium histolyticum collagenase and penile traction therapy: a prospective, multicenter, single-arm study [published online ahead of print, 2020 May 4]. Int J Impot Res. 2020. https://doi.org/10.1038/s41443-020-0292-y.

68.

Hughes W, Natale C, Hellstrom WJG. The management of penile fracture: a review of the literature with special consideration for patients undergoing collagenase Clostridium histolytica injection therapy. Curr Urol Rep. 2020; (In Press).

69.

Alenghat FJ, Ingber DE. Mechanotransduction: all signals point to cytoskeleton, matrix, and integrins. Sci STKE. 2002;2002(119):pe6.PubMed

70.

Ziegelmann M, Savage J, Toussi A, et al. Outcomes of a novel penile traction device in men with Peyronie’s disease: a randomized, single-blind, controlled trial. J Urol. 2019;202(3):599–610.PubMed

71.

Alom M, Sharma KL, Toussi A, Kohler T, Trost L. Efficacy of combined collagenase Clostridium histolyticum and RestoreX penile traction therapy in men with Peyronie’s disease. J Sex Med. 2019;16(6):891–900. https://doi.org/10.1016/j.jsxm.2019.03.007.CrossRefPubMed

72.

• Ziegelmann MJ, Viers BR, Montgomery BD, Avant RA, Savage JB, Trost LW. Clinical experience with penile traction therapy among men undergoing collagenase Clostridium histolyticum for Peyronie disease. Urology. 2017;104:102–9. https://doi.org/10.1016/j.urology.2017.01.054. In this randomized-controlled trial of 110 patients with PD and curvature of 30° or greater, patients were assigned to either 30 or 90 min of traction therapy per day with the RestoreX device. The study reported significant improvement in penile curvature and length in those treated with the traction device compared to the control group. Time for traction therapy treatment in this study was significantly shorter than is typically required.CrossRefPubMed

73.

Yafi FA, Pinsky MR, Stewart C, Sangkum P, Ates E, Trost LW, et al. The effect of duration of penile traction therapy in patients undergoing intralesional injection therapy for Peyronie’s disease. J Urol. 2015;194(3):754–8. https://doi.org/10.1016/j.juro.2015.03.092.CrossRefPubMed

74.

• Haney NM, Kohn TP, Nichols PE, Hellstrom WJ. The effect of adjunct mechanical traction on penile length in men undergoing primary treatment for Peyronie’s disease: a systematic review and meta-analysis. Urology. 2018;122:110–5. https://doi.org/10.1016/j.urology.2018.07.039. This systematic review evaluated 4 studies, and 348 total patients, which included penile traction therapy as an adjunct treatment for PD. On meta-analysis, there was a significantly greater stretched penile length in men treated with traction therapy after their primary intervention compared to those not treated with penile traction. This improvement was not significantly different in the surgical vs. injection therapy subgroups.CrossRefPubMed

75.

• Wymer K, Kohler T, Trost L. Comparative cost-effectiveness of surgery, collagenase Clostridium histolyticum, and penile traction therapy in men with Peyronie’s disease in an era of effective clinical treatment. J Sex Med. 2019;16(9):1421–32. This cost analysis determined that RestoreX traction therapy was the most cost-effective treatment compared to surgery and CCH therapy.PubMed

76.

Raheem AA, Garaffa G, Raheem TA, Dixon M, Kayes A, Christopher N, et al. The role of vacuum pump therapy to mechanically straighten the penis in Peyronie’s disease. BJU Int. 2010;106:1178–80.PubMed

77.

Cowper MG, Burkett CB, Le TV, Scherzer N, Hellstrom WJG. Penile stretching as a treatment for Peyronie’s disease: a review. Sex Med Rev. 2019;7(3):508–15. https://doi.org/10.1016/j.sxmr.2018.11.002.CrossRefPubMed

78.

Lingeman JE, McAteer JA, Kempson SA, Evan AP. Bioeffects of extracorporeal shock wave lithotripsy: strategy for research and treatment. Urol Clin North Am. 1988;15:507–14.PubMed

79.

Palmieri A, Imbimbo C, Longo N, Fusco F, Verze P, Mangiapia F, et al. A first prospective, randomized, double-blind, placebo-controlled clinical trial evaluating extracorporeal shock wave therapy for the treatment of Peyronie’s disease. Eur Urol. 2009;56:363–70.PubMed

80.

Chitale S, Morsey M, Swift L, Sethia K. Limited shock wave therapy vs sham treatment in men with Peyronie’s disease: results of a prospective randomized controlled double-blind trial. BJU Int. 2010;106:1352–6.PubMed

81.

Palmieri A, Imbimbo C, Creta M, Verze P, Fusco F, Mirone V. Tadalafil once daily and extracorporeal shock wave therapy in the management of patients with Peyronie’s disease and erectile dysfunction: results from a prospective randomized trial. Int J Androl. 2012;35:190–5.PubMed

82.

Hatzichristodoulou G, Meisner C, Gschwend JE, Stenzl A, Lahme S. Extracorporeal shock wave therapy in Peyronie’s disease: results of a placebo-controlled, prospective, randomized, single-blind study. J Sex Med. 2013;10:2815–21.PubMed

83.

• Di Mauro M, Russo GI, Della Camera PA, et al. Extracorporeal shock wave therapy in Peyronie’s disease: clinical efficacy and safety from a single-arm observational study. World J Mens Health. 2019;37(3):339–46. https://doi.org/10.5534/wjmh.180100. In this single-arm, multi-institutional study, 325 consecutive patients were treated with ESWT for PD. The authors reported significant reductions in median plaque size and penile curvature, as well as increased median erect penile length and IIEF and improved PDQ subdomains.CrossRefPubMedPubMedCentral

84.

Sexual Medicine Society of North America. Position statement: ED restorative (Regenerative) therapies (shock waves, autologous platelet rich plasma, and stem cells). 27 March, 2018. PDF: https://www.smsna.org/V1/images/SMSNA_Position_Statement_RE_Restorative_Therapies.pdf. Accessed 25 Sept 2020.

85.

Pietsch G, Anzeneder T, Bruckbauer H, et al. Superficial radiation therapy in Peyronie’s disease: an effective and well-tolerated therapy. Adv Radiat Oncol. 2018;3(4):548–51. Published 2018 Aug 7. https://doi.org/10.1016/j.adro.2018.07.009.CrossRefPubMedPubMedCentral

86.

Tsambarlis P, Levine LA. Nonsurgical management of Peyronie’s disease. Nat Rev Urol. 2019;16(3):172–86. https://doi.org/10.1038/s41585-018-0117-7.CrossRefPubMed

87.

Mahmood J, Shamah AA, Creed TM, et al. Radiation-induced erectile dysfunction: recent advances and future directions. Adv Radiat Oncol. 2016;1(3):161–9 Published 2016 Jun 3.PubMedPubMedCentral

Title: Conservative Therapy for Peyronie’s Disease: a Contemporary Review of the Literature
Authors: Ayad Yousif
Caleb Natale
Wayne J. G. Hellstrom
Publication date: 01-02-2021
Publisher: Springer US
Keywords: Conservative Therapy
Pentoxifylline
Verapamil
Published in: Current Urology Reports / Issue 2/2021
Print ISSN: 1527-2737
Electronic ISSN: 1534-6285
DOI: https://doi.org/10.1007/s11934-020-01024-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Conservative Therapy for Peyronie’s Disease: a Contemporary Review of the Literature

Abstract

Purpose of Review

Recent Findings

Summary

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

Please log in to get access to this content

Other articles of this Issue 2/2021

“Pumpology”: the Realistic Issues Associated with Pump Placement in Prosthetic Surgery

Current Status for Semirigid Penile Prosthetic Devices

Chronic Scrotal Content Pain: a Review of the Literature and Management Schemes

The Management of Penile Fracture: a Review of the Literature with Special Consideration for Patients Undergoing Collagenase Clostridium Histolyticum Injection Therapy

Imaging in Gender Affirmation Surgery

Penile Cancer: Managing Sexual Dysfunction and Improving Quality of Life After Therapy