Peyronie’s Disease: A Treatment Overview

Treatment During the Acute Phase

The acute phase is when the plaque is still forming and pain is often present. The goal during this phase is to manage pain and potentially limit the extent of the curvature. Options include:

• Oral Medications: Drugs like nonsteroidal anti-inflammatory drugs (NSAIDs) for pain, and others like Potaba or colchicine may be used to try to reduce inflammation and plaque formation, although their effectiveness is debated.
• Traction Therapy: The use of a penile traction device for several hours a day has shown some promise in reducing curvature and regaining length.

Treatment During the Chronic Phase

Once the plaque has stabilized and the pain has subsided (usually after 6-12 months), more definitive treatments can be considered if the curvature is affecting sexual function.

Non-Surgical Options

• Injection Therapy: This is a common non-surgical approach. Medications like Verapamil, Interferon, or Collagenase (Xiaflex) are injected directly into the plaque. These drugs work to break down the fibrous tissue and reduce the curvature. This typically requires a series of injections over several weeks or months.

Surgical Options

Surgery is the most effective treatment for correcting the curve but is typically reserved for men with severe deformity that prevents intercourse. The main surgical options are:

• Plication (or Nesbit) Procedure: This involves placing sutures on the side of the penis opposite the plaque to straighten it. It is a relatively simple procedure but can result in some loss of penile length.
• Grafting Procedure: This involves cutting the plaque and inserting a graft (made of natural or synthetic material) to fill the gap. This can preserve length but has a higher risk of causing erectile dysfunction.
• Penile Implant: For men with both Peyronie's disease and significant erectile dysfunction, placing a penile implant is often the best option. The implant itself provides rigidity and often straightens the penis.