Traditional

Traditional treatments are defined as treatments that have been widely prescribed, recommended, or practiced by doctors having an interest in, and experience with Peyronie’s Disease. As with all treatments, individual physicians have their preferred treatments and many of these treatments may not be available from a given physician.  Also keep in mind that this is not an all inclusive list but cover the most currently most common traditional treatments.

Non-Invasive

Non-invasive treatments include oral and topical treatments that have been widely recommended or prescribed by doctors over the years, and that continue to be prescribed.  As with most treatments, different doctors prefer and recommend different traditional treatments.

Vitamin E – Varying types of this over the counter vitamin is often recommended in varying doses.  We know of no clinical studies that have ever established the effectiveness of vitamin E for Peyronie’s Disease.  The risks and cost of this vitamin is low so many incorporate this into their treatment plan with a “what can it hurt attitude”

Cholchicine – This is a prescription medication long used for gout.  It is thought to reduce inflammation during acute phases of Peyronies Disease.  It also is known to interfere with the formation of scar tissue.  We know of no objective clinical studies that have been made on Cholchicine and its effectiveness with any phase of Peyronies Disease.  Cholchicine often has the side effect of stomach upset and diarhea (which often resolves in the initial weeks).  It also can have less common but more serious side effects such as suppression of white blood cell production.

Potaba  – (Aminobenzoate Potassium) Potaba is used to treat fibrosis, a condition in which the skin and underlying tissues tighten and become less flexible. This condition occurs in such diseases as dermatomyositis, morphea, scleroderma, and Peyronie’s disease. The dosage on this medication is often 24 pills a day and it is very common for it to cause significant upset of the digestive system and nausea.  While some limited studies have show it to stop the progression of acute Peyronies Disease, these studies are limited.  We know of no studies that indicate any reversal.


Invasive

Verapamil intraleasional Injections (VI) or (ILV) – Trained Urologists can inject Verapamil, a calcium channel blocker, directly into the plaque. This is referred to as Verapamil Injections (VI) or Intralesional Verapamil (ILV).  The verapamil is intended to break down scar tissue deposits and result in replacement with healthy tissue.  The process requires several injections over a period of months.

Xiaflex was approved by the FDA in December of 2013. It is injected and works very similarly to Verapamil. And is commonly used in place of Varapamil currently.

Reports of success from Verapamil and Xiaflex are mixed. Many men on our forum have, or are currently receiving this treatment.  There are reports of some men having a favorable response or curve reduction. But as with many Peyronies treatments what works for some doesn’t necessarily work for all.

Surgery

There are several factors to evaluate when considering surgery including various types of surgical procedures. Other treatment options are generally considered for curvatures less than 40 degrees. But in severe cases where curvature is greater than 40 degrees and making it a challenge or even impossible for intercourse, then you might be a candidate for surgery. It is important to find a qualified surgeon who specializes in the treatment of Peyronies and has performed surgeries on a regular basis. Also you should wait for a minimum of 12-18 months from the first onset of Peyronies to insure you are past the active phase of Peyronies and it has stabilized.  The importance of seeking out a very skilled surgeon cannot be over emphasized and there several surgeons recommended on the Peyronies Forum.

Nesbit tuck – Tissue on the opposite side of the penis is removed or pinched, canceling the bending effect. This surgery shortens the long side of the penis to match the constricted side in order to cancel the bend. (see illustration)

This  procedure is ineffective for narrowing or hourglass deformity

Nesbit Procedure

Plaque excision. – The plaque is removed and replaced with a patch of skin.

Plaque incision with graft. Several cuts are made in the plaque, this allows straightening. The cut plaque is then covered with a grafted which can include one of several materials.

Prosthesis Implant – All natural erectile tissue is removed from the penis and one of several types of prosthesis is implanted.  The most advanced of these are hydraulic manual pump with the fluid reservoir implanted in the lower abdomen and the miniature pumps in the scrotum.  With a hydraulic implant the penis increases in girth when pumped to an erect state but not in length.