THE BEST TREATMENTS FOR PENILE CURVATURE

HOW DOES PEYRONIE’S DISEASE OCCUR?

1. Trauma – Though the exact cause is unknown, many cases are because of a traumatic episode like bending of the penis during sex with a flaccid penis

2. Attempted Repair – Injury results in small tears in the muscle fibers and the layer supporting it. The body senses microtears and attempts to repair it by sending blood to the area

3. Scarring – If you have poor blood flow (like if you had ED), the area cannot get enough blood flow and oxygen. The lack of oxygen causes the area of injury to die and form scar tissue

ACTIVE PHASE

During the active phase, the scar tissue is actively forming and disease will continue to progress. There is worsening penile pain and progression of bending and scar tissue. This phase typically lasts 12-18 months. The goal of treatment is to limit any worsening of your curvature or scarring, increase blood flow into the penis, and treat penile pain.

CHRONIC PHASE

During the chronic phase, the scar tissue has stabilized. There has not been any change in the plaque or curvature for atleast 6 months. There may be a discomfort with intercourse related to the curvature or underlying erectile dysfunction. The goal of treatment is to correct the curvature and fix any underlying erectile dysfunction.

1. Topical Medicines – Topical medicines such as verapamil are rarely effective and are often expensive. These medications were normally used to treat high blood pressure. It is used to disrupt the production of collagen, a key factor in the formation of Peyronie’s disease scar tissue.

2. Oral Medications – Oral medications such as PDE5 inhibitors, L-Argenine, and Pentoxyphylline work to improve blood flow to the areas of scar to help the area heals. By increasing blood flow the goal is to prevent further worsening of the disease.

3. Vacuum Erection Device – A vacuum device is a cylinder placed on the penis that creates a vacuum to draw blood into the penis as well as increasing straightening and stretching of the penis. This helps decrease progression and shortening of the penis.

4. Traction Device / Penile Modeling – Penile remodeling involves massaging the plaque and manually straightening. Traction therapy involves the use of devices to pull the penis straight or bend it against the curve.

1. Penile Injection Therapy (XIAFLEX) – This is a minimally invasive in office injection treatment that breaks down collagen, the primary component of the scar tissue in Peyronie’s disease.

2. Plication – Plication therapy straightens the penis by shortening the penis on the side directly opposite the plaque. This results in a straight penis but can result in minor shortening of your penile length. This is sometimes used for curvature less than 60 degrees and is highly effective. Recovery time is quick, typically about 3 weeks.

3. Plaque Incision and Grafting – Plaque incision and grafting is a technique where the plaque is incised or removed and the tissue is replaced with a graft. This is done for curvature over 60 degrees and typically will allow you to regain lost penile length. There is a risk of decreased penile sensation, urethral injury, or worsened erectile dysfunction associated with this procedure.

4. Advanced Penile Implant – Advanced penile prosthesis provides the GOLD STANDARD TREATMENT for patients with both Peyronie’s disease and Erectile Dysfunction as ot corrects both issues. This minor surgery results in high quality of life and is a durable long term solution. We have the best implant surgeons in the Southeast with Drs. Shah, Dave, and Farber. Advanced has one of the only Centers of Excellence in the state.

5. Penile Remodeling / Traction Therapy – Penile remodeling involves massaging the plaque and manually straightening the penis after treatment. Traction therapy involves the use of devices to pull the penis straight.