Peyronie's Disease (Curvature of the Penis) (cont.)
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Jerry R. Balentine, DO, FACEP
Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
In this Article
- What is Peyronie's disease?
- What causes Peyronie's disease?
- What are the symptoms of Peyronie's disease?
- How is Peyronie's disease diagnosed?
- How is Peyronie's disease treated?
- What are the complications of Peyronie's disease?
- What is the prognosis for Peyronie's disease?
- Find a local Doctor in your town
How is Peyronie's disease diagnosed?
The patient's history of pain with erections and/or sex and the physical examination of the penis that shows abnormal angulation of the penile shaft or the presence of plaque or scarring felt or palpated in the penis is usually the basis for diagnosis. Urologists are specialists that usually diagnose and treat this disease. There are no definitive blood tests for this disease, although a human cell antigen, HLA-B7 has been associated with the disease. In general no additional tests are necessary , but ultrasound techniques, when accompanied by an injection of drug into the penis (intercavernous injection) can help show the doctor where and how extensive is the scarring, and aid the doctor in determining treatments.
How is Peyronie's disease treated?
There is no treatment that will cure Peyronie's disease. However, there are several types of treatments that are designed to reduce the symptoms of the disease. Oral therapy with vitamin E, colchicine, PABA, tamoxifen, and other medications have been tried with limited success in some patients. Usually those in the acute phase of the disease responded best.
Injection therapy using combinations of drugs mentioned above and adding prostaglandin E1 or other drugs such as betamethasone alone or with hyaluronidase have also been used with varying degree of success. Verapamil (Calan, Verelan, Verelan PM, Isoptin, Isoptin SR, Covera-HS [a medication usually used for high blod pressure treatment]) appears to disrupt the production of a protein involved in the formation of Peyronie's disease.
Another method is iontophoresis (also termed electromotive administration or EMDA) where verapamil and other drugs are applied to the penile skin and pushed through the skin with a low electrical current.
Shockwave therapy (done with a lithotripter device like those used to break up kidney stones) has been used on plaque or scaring that is calcified. Other mechanical devices, including vacuum-based machines and low-dose radiotherapy have been tried. Although some successes are seen with these methods, best results are in acute phase patients. There are ongoing studies with different drugs (interferon, collagenase clostridium histolyticum [Xiaflex], collagenase) and surgical techniques.
Surgical therapy is done on some patients. These surgical patients usually have to meet criteria that may vary from surgeon to surgeon. In general, surgical therapy is done when other methods have failed or the patient is in the chronic stage of the disease and erectile dysfunction is part of the patient's symptoms. Surgical therapy may involve incision or cutting the scarred tissue, scar tissue removal, scar tissue removal with auto-grafting or artificial graft material. In addition, implanted devices that allow the patient to sustain an erection are also utilized in some individuals.
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