How is Peyronie’s Disease Treated?

PD Treatment Options

A common question men ask is, “I have Peyronie’s disease symptoms.  What should I do next?”  As with many conditions, it comes down to severity and duration, but the quicker you act the better off you will likely be.  If you suspect you have Peyronie’s disease and it’s causing distress, you should make an appointment with your local urologist or health care provider to properly diagnose your situation and discuss treatment options, including H100.

As mentioned on this site, in a very small percentage of men, both curvature and pain will improve without treatment.  But what about everyone else?  What options are there?

Oral Medications

To date, controlled trials have failed to show any reliable efficacy with oral treatments.  Vitamin E, Tamoxifen, Carnitine and Colchicine have shown no improvement over placebo in recent controlled studies.  Potassium amino-benzoate (Potaba) has shown no significant benefit in recent controlled studies.  It’s expensive and can cause GI issues.  Unfortunately there’s no “magic” pill.

Topical Treatments

Verapamil has been tried as a topical gel, rubbed on the penis. There is little evidence to show that the drug reaches the diseased tissue.

Hybrid Medical has conducted an IRB approved clinical trial with H100 in a placebo-controlled, double-blinded IRB study that showed statistically significant improvement in penile length, curvature and pain. (1)  After more than a decade of research and development H100, an easy to apply in-home treatment for sufferers of Peyronie’s disease, is available to select patients in the U.S.

What makes H100 most promising are independent studies on its key ingredients.  Superoxide dismutase is used to treat inflammatory diseases and has been shown to effective in Peyronie’s Disease treatment. (2)  Nicardipine has been shown to be clinically effective when injected into Peyronie’s disease tissue.(2)  Emu oil has been shown to be an extremely effective transdermal carrier, and may have anti-inflammatory and scar remodeling properties.  (4)(5)(6).  It has historically been used by Aborigines to treat burns, wounds and scar tissue.

Penile Traction Device

Some studies have shown significant results with penile traction devices, although there is not a clear consensus among health experts and consumers.  What many health experts recommend is to supplement other PD treatment with traction devices to help remodel the scar tissue.

Vacuum erection devices (VED’s) provide more benefit in length than curvature.

Injections

Injections have shown better success than oral and topical treatments for some patients.  The idea is to inject the affected area with a higher dose of drug.  Injections are not painless but compared to surgery it may be a better option for you.  Some studies have shown multiple Verapamil injections over months had some improvement in pain and curving.  Verapamil was approved by the FDA in the 80’s for hypertension heart conditions.  Verapamil Injections still need more studies before conclusions can be drawn.

Interferon Injections also fall into this “need more studies” category.  Injections into the affected area of the penis can possibly help reduce scarring.

The only FDA approved treatment for Peyronie’s disease is Xiaflex®.  To be a candidate, you must have more than a 30-degree penis curvature, your PD needs to be in the Stable phase and you must have a plaque that can be felt.  Xiaflex is expensive and does come with possible side effects including bruising, swelling, itching, painful erections and blisters.

Peyronie’s Disease Surgery

After exploring all non-surgical treatments, for many men, surgical repair with either plication or grafting remains one of the last and most effective option.  It is normally recommended for Chronic phase (12-18 months after onset) patients with severe PD who have not found success through non-surgical options.  To be a candidate, your PD must be stable.

Plication is the process of stitching the longer, non-diseased side of the penis to create a straight erection.  Grafting is when the diseased, shorter side of the penis is repaired with a vein or tissue graph.  Grafting is a more complex, overnight hospital procedure with patients back to work in a few days and resumed sexual activity in eight to ten weeks.  Plication is normally an outpatient procedure, with patients back to work in a few days and resumed sexual activity in four to six weeks.

Since this is surgery, it does come with risks.  Plication cannot fix hourglass condition and has a small risk of nerve injury and/or impotence.  Grafting has a higher risk of nerve injury and impotence, depending on the patient.  Talk to your doctor about any concerns you have about your situation.

1. J Twidwell, L Levine. Topical treatment for acute phase Peyronie’s disease utilizing a new gel, H-100: a randomized, prospective, placebo-controlled pilot study. International Journal of Impotence Research (2016) 28, 41–45; doi:10.1038/ijir.2015.22
2. Riedl C, Sternig P, Galle G, Langmann F, Vcelar B, Vorauer K et al. Liposomal recombinant human superoxide dismutase for the treatment of Peyronie’s disease: a randomized placebo-controlled double-blind prospective clinical study. Eur Urol 2005; 48: 656–661.
3. Soh J, Kawauchi A, Kanemitsu N, Naya Y, Ochial A, Naltoh Y et al. Nicardipine vs saline injection as treatment for Peyronie’s disease: a prospective, randomized, single-blind study. J Sex Med 2010; 7: 3743–3749.
4. Zemtsov A, Gaddis M, Montalvo-Lugo V. Moisturizing and Cosmetic Properties of Emu Oil: A Double Blind Study. Australas J Dermatol 1996; 37: 159–161.
5. Qiu XW, Wang JH, Fang XW, Gong ZY, Li ZQ, Yi ZH. Anti-inflammatory activity and healing-promoting effects of topical application of emu oil on wound in scalded rats. [Article in Chinese]. Di Yi Jun Yi Da Xue Xue Bao 2005; 25: 407–410.
6. Yoganathan S, Nicolosi R, Wilson T, Handelman G, Scollin P, Tao R et al. Antagonism of croton oil inflammation by topical emu oil in CD-1 mice. Lipids 2003; 38: 603–607.