Erectile Dysfunction: Peyronie's Disease
What Treatments Are Available?
Possible treatments for Peyronie's disease include surgery and medical treatment.
The FDA has approved the first drug for treating Peyronie's disease, Xiaflex. It is believed to work by breaking down the scar tissue that causes the curvature.
Men get as many as four treatments, each of which is two injections of the drug. There’s also surgery to straighten the penis.
Side effects may include pain, bruising and swelling.
The two most common surgeries used to treat Peyronie's disease are:
- Removal of the plaque followed by placement of a tissue patch.
- Removal or altering the tissue from the side of the penis opposite the plaque, which counters the disease's bending effect.
Unfortunately, the surgeries do not guarantee normal penis function. 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.
Another surgery for Peyronie's disease is penile prosthesis implantation. This treatment is reserved for men who have both Peyronie's disease and significant erectile dysfunction (inability to obtain or maintain an erection suitable for intercourse).
Most types of surgery produce positive results. But because complications can occur, and because many of the complications associated with Peyronie's disease (for example, shortening of the penis) cannot be corrected, most doctors prefer to perform surgery only on the small number of men with curvature so severe that it prevents sexual intercourse.
Some studies have shown that vitamin E improves Peyronie's disease. Similar studies have been done on para-aminobenzoate, a substance related to B-complex vitamins, but the results have been inconclusive. Both of these substances theoretically decrease or inhibit the scar tissue (plaque) formation.
Other approaches to treating Peyronie's disease that have yet to be confirmed as effective include the injection of chemical agents directly into the plaque or radiation therapy. However, because radiation therapy can only relieve pain associated with Peyronie's disease and pain frequently disappears without treatment, it is seldom performed.
Since the severity of the condition varies from person to person, talk to your doctor about what treatment strategy is right for you.
In the majority of men with penile pain due to Peyronie's disease, the discomfort usually will resolve on its own as the penile injury heals and matures over time. This process may take as long as six to 18 months. In certain instances, the calcium channel blockers Calan or Isoptin may be effective in decreasing the pain related to Peyronie's disease when injected directly into the penile scar or plaque.
What Is the Outlook for Peyronie's Disease?
Peyronie's disease may be a self-limiting condition. Pain usually disappears with time, plaque formation stops, and the erection deformity stabilizes. Most men with Peyronie's disease are able to have sexual intercourse and mutual enjoyment with their partner.