In a nutshell
This study looked at the different injection and mechanical therapies available to treat Peyronie's Disease (PD). It concluded that injection treatments were better than mechanical therapies for PD.
Some background
Peyronie’s disease (PD) is an abnormal curvature of the penis when it is erect. The curvature is caused by scar tissue, called a plaque, forming in the penis. Surgery to remove the scar tissue is an option to treat PD, though it can be associated with complications. Other therapies inlcude medication and mechanical devices. Medications can be injected into the penis.
This review outlines the available injectable medications and mechanical devices for PD.
Methods & findings
Databases were searched for studies looking at patients with PD. These studies used injections or mechanical devices to treat PD. 52 studies were included. These studies mainly looked at penile curve, penile pain, plaque size and penile length.
Injections:
Verapamil (Calan), given on its own, could improve penile curve and plaque size without impacting erectile function. Verapamil given electric shock treatment improved penile pain. Verapamil with hyaluronic acid (Hyalgan), penile traction or thiocolchicine (Muscoril) improved penile curve. Though the evidence to support verapamil was weak. Hyaluronic acid given alone showed no significant improvement in PD symptoms. The studies included were also small and did no statistical analysis. Nicardipine (Cardene) improved penile pain but not curve. Interferon alpha 2 beta (IFNa2b) improved penile curve in between 17-22% of patients in the studies. It could improve penile curve by 30 degrees. It did not improve plaque size, erectile function or penile pain. Collagenase clostridium hystoliticum (CCH) improved penile curve in some studies but not all. It worked best when combined with penile traction. CCH and traction improved penile curve in 34% of patients. CCH alone also improved erectile function and penile length. CCH improved PD best overall.
Mechanical:
The studies looked at, did not provide any significant evidence for the use of mechanical devices in the treatment of PD. The studies had conflicting evidence.
The bottom line
The authors concluded that IFNa2b and CCH were the best injection therapies for PD. It also concluded that there was not much evidence for mechanical therapies in the treament of PD.
The fine print
The authors note that the evidence is not of a high enough standard to draw strong conclusions on any of the therapies looked at.
What’s next?
If you are interested in learning more about possible PD therapies, talk to your doctor.
Published By :
European Urology
Date :
Sep 17, 2018
