What is Peyronie’s Disease ?

What is Peyronie’s Disease? Learn About PD and Treatments

What causes Peyronie’s disease?

The most common cause of Peyronie’s Disease is from strenuous sex where the penis is bent during penetration. Other causes include accidents or sports activity. In many cases, no specific injury is recalled which makes the exact cause of Peyronie’s Disease difficult to determine.

There are other factors health experts believe may play a role in the cause of Peyronie’s Disease. These include age (most prevalent in men over 40), heredity and some form of connective tissue disorder. Men who have PD also have an increased risk Dupuytren’s contracture which is a gradual thickening of tissue under the skin of the hand/palm. As this tissue thickens, it feels like a rope or hard cord that causes the fingers to stay bent inward.

What does Peyronie’s disease look like?

An Anatomical Description of Peyronie’s Disease

The penis contains two tubes called “corpora” which fill with blood during an erection. Each corpora is long, tubular and has an outer casing of strong elastic tissue that stretches and expands during an erection. The inner portion of each corpora is filled with blood vessels.

With Peyronie’s disease, inflammation occurs in the wall of the corpora. During the healing process, scar tissue can form as a nodule, lump or bump on the penis. Consequently, the area with scar tissue doesn’t stretch, so the penis curves and there can be pain in the penis.

You’re Not Alone – Peyronie’s disease is more common than you might expect

The National Institute of Health estimates that 3-9% of adult men experience Peyronie’s disease. This represents between 130 million – 290 million men worldwide, though the number may be even higher because patients do not always seek medical help. According to some health experts, Peyronie’s disease is considered relatively common with an estimated 200,000+ cases in the U.S. alone yearly.

The curvature associated with Peyronie’s disease (bent penis) may gradually worsen and become more difficult to treat over time, so it’s important to seek Peyronie’s disease treatment as soon as possible.

 

  1. Safarinejad, A double-blind placebo-controlled study of the efficacy and safety of pentoxifylline in early chronic Peyronie’s disease, 2009 BJU International, 106,240-248
  2. Schaefer, Nonsurgical Interventions for Peyronie Disease: 2011 Update, Journal of Andrology, Vol. 33, No. 1, January/February 2012
  3. DiBenedetti, A Population-Based Study of Peyronie’s Disease: Prevalence and Treatment Patterns in the United States, Advances in Urology, Vol 2011, Article ID 282503, 9 pages
  4. Pryor, Clinical presentations of Peyronie’s disease, Int J of Imp Res (2002), 14, 414-417
What is the progression timeline of Peyronie’s disease?


Peyronie’s disease has Acute and Chronic phases/stages. The acute phase generally occurs within the first 12-18 months after injury and is characterized by active inflammation and scar tissue development. In the chronic phase, after 12-18 months, the inflammation typically subsides, and the disease stabilizes. Different Peyronie’s disease treatments may be more appropriate depending on the PD phase.

Treating the scar tissue immediately in the Acute stage (up to the first 18 months of onset) by stopping its’ formation and hardening is thought by many health experts to be central to Peyronie’s disease treatment. After 12-18 months (Chronic stage) the fibrous scar tissue hardens and painful erections generally decrease, but the penis curve remains.

How is Peyronie’s disease treated?

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.
Is there a cure for PD and how can Hybrid Medical H100 help?

There is no known “cure” for Peyronie’s disease. However, there are effective treatments available to alleviate and improve symptoms, including non-surgical options. First, although its name contains the word “disease”, it is not contagious or transmittable. The bumps or lumps are plaque in the penis and are not cancerous; they are benign. The PD plaque (scar tissue) is not the same type that can develop in your arteries.

The acute phase is when Peyronie’s disease is developing and causing inflammation as the body tries to heal itself. Peyronie’s disease involves a cascade of events in which trauma leads to inflammation which leads to scar tissue (plaque). Changing the natural course of this cascade is the focus of our research.

We developed H100, a Peyronie’s disease treatment designed to target inflammation, scar tissue remodeling, and plaque development. As documented in prior independent studies, Nicardipine and Superoxide dismutase can accomplish this. 1,2 We combined these ingredients with ultra-purified emu oil which contains the fatty acids necessary to be an effective carrier agent. 3,4,5 Emu oil also has been used for centuries by the Aborigines for scar tissue remodeling. H100 is an in-home treatment option for PD sufferers.

We recommend using H100 in the Acute phase for three months and if you remain stable or improve, continue for a total of six months.  For best results, we recommend H100 in conjunction with a penile stretching / remodeling activity during the course of treatment.

 Hear Dr. Twidwell discuss H100 research, ingredients and intended users.

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
Do I need Peyronie’s disease treatment?

Many need treatment however in a small percentage of cases, both the curvature and penis pain associated with Peyronie’s disease improve without treatment. However, many people seek medical help and consider treatment for their specific situation. Everybody reacts differently to different treatments, so it’s important to discuss all options with your health care provider.

  1. Gelbard MK, Dorey F. James K. They natural history of Peyronie’s disease. J Urol. 1990;144(6):1376-1379
Is it normal for a penis to be curved and what causes it?

Yes, it is normal for a penis to be curved, and each person’s curve can be different. There are several factors unique to each male that determines whether, and to what extent, the erect penis curves. Some men are born with different length penile corpora (corpora disproportion) that can manifest as a curve. This is not Peyronie’s disease and usually does not require treatment.

However, when there is an extreme curve, usually accompanied by penis lumps or bumps and painful erections, this may be Peyronie’s disease. In these cases, it is best to seek medical attention as soon as possible since earlier Peyronie’s disease treatment can have better results. Schedule an appointment with your urologist or medical provider and discuss Hybrid Medical’s H100 as a possible treatment option.

Are there any Peyronie’s disease natural, herbal or alternative treatments?

As with any human condition, there are many resources claiming they have the cure with herbs, vitamins or magic potions.  Each person suffering from Peyronie’s disease is different and like any treatment, people will react differently.  The key to any treatment is its ability to attack the plaque (scar tissue) that causes PD.

As for natural treatments and herbs, there has been no scientific proof or controlled study proving viability.  This does not mean they can’t be tried, but please temper your expectations accordingly and research the active ingredients for published studies of its effect on plaque.

We developed a Peyronie’s disease treatment that is designed to target inflammation, scar tissue remodeling, and plaque development.  As documented in prior independent studies, Nicardipine and Superoxide dismutase can accomplish this1,2.  We combined these ingredients with ultra-purified emu oil which contains the fatty acids necessary to be an effective carrier agent3,4,5.  Emu oil also has been used for centuries by the Aborigines for scar tissue remodeling.

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.