Men with Peyronie’s disease usually consult a doctor for painful erections, penile deformity or difficulty with intercourse. The exact cause of the disease is not known and therefore, doctors treat the disease empirically (i.e. use medications and methods that seem to help). Aim of treatment is to manage pain and maintain or restore the ability to have intercourse.
Treatment options for Peyronies Disease include:
Patient education: Studies do not suggest that any treatment other than surgery is probably effective. Hence, educating the patient about the disease and its course is very important. As the disease may stabilise and symptoms may improve gradually, most experts suggest waiting 1 year or longer before having surgery. Surgery is recommended only after the disease stabilises and if the deformity prevents intercourse.
Drug treatment: Medications have been shown to have limited efficacy. They are usually considered for men with early or active Peyronie's disease (cases in which the lump is expanding or is painful). Aim of medications is to reduce pain, lump size and the eventual deformity. Some medications that are used to treat symptoms of Peyronie's disease include:
Extracorporeal shockwave therapy: This is a treatment, which is used for the management of kidney stones and gallstones. Some studies have shown it to be effective for the treatment of Peyronie's plaques. The shockwaves are directed at Peyronie's plaques in cases with established and stable disease. It may reduce penile deformity and avert the need for surgery in established Peyronie's disease. It is an outpatient treatment, which is given over several sessions. The technique, however, is still under investigation for the management of Peyronie's disease and is not yet widely available.
Surgery: Surgery is usually indicated for men with:
As the disease progresses variably, most experts recommend conservative approach to treatment and avoid early surgical intervention. Surgery to correct penile deformity is done in men with stable Peyronie's disease that has been present for at least a year and has not progressed for at least three months. If surgery is attempted before the disease has stabilized, the condition may continue to progress after the operation has been performed.
Types of surgery done for Peyronie's disease include:
Success of surgery is assessed by correction of deformity, but in many cases, the penis may not become straight after surgery. Apart from this, some men may develop erectile dysfunction or even numbness of the penis following surgery. Therefore, surgery is usually not attempted without considerable caution.
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