Conservative treatment of Peyronie's disease

Conservative treatment of Peyronie's disease possible in the acute phases and in the initial stages. With pills and injections may relieve pain, stop inflammation. To get rid of the external signs of the curvature of the member is possible only by injection into the plaque or surgically.

Peyronie's Disease

At the first symptoms of penile curvature, it is necessary to consult a specialist. The doctor andrologist will select for you the optimal solution to the problem. After diagnosis perhaps the appointment of conservative therapy.

How to cure Peyronie's disease without surgery: principles of therapy

The basic principles and objectives of conservative treatment of Peyronie's disease are:

  • the removal of the acute inflammatory process, reducing its area and intensity in the tunica albuginea of the penis;
  • reduction of pain syndrome;
  • preventing the formation of plaques;
  • the decrease in the area or (if possible) the complete dissolution of the plaque;
  • may require a conservative treatment for Peyronie in the postoperative period .

Perhaps the use of physiotherapy, oral medications, topical therapy, injection therapy. To cure Peyronie's disease in the early stages it can only help the complex therapy, which will include several approaches.

Drugs for the treatment of Peyronie's disease

There are a number of drugs that have passed clinical trials and is effective in Peyronie's disease. Each of them provides its effect, while focused on different stages of pathogenesis, which requires their integrated application.

Only when the internal examination and Doppler ultrasound of the penis doctor may suggest what type of treatment can be effective (much depends on the causes of the disease).

Treatment of Peyronie's disease without surgery paraaminobenzoic

This medication has a number of beneficial therapeutic effects:

  • inhibits proliferation of fibroblasts;
  • reduces the secretion of mucopolysaccharides and glycosaminoglycans;
  • increases the absorption of oxygen by the tissues of the penis;
  • inhibits fibrinogenez.
Injection

Injection

Indicated for the treatment of adult men with Peyronie's disease with a sensitive plaque and curvature deformity of at least 30 degrees at the beginning of therapy. Injected directly into the plaque. Each injection helps to reduce and destroy plaque and help straighten the curvature of penis, called Peyronie's disease.

Vitamin E for Peyronie's disease

Vitamin E fat-soluble antioxidant that inactivates free radicals, which are saturated with nitric oxide (NO), thereby maintaining elevated levels of active NO to ensure proper healing. Limiting oxidative stress, it is also potentially anti-inflammatory effect. It was first described for the treatment of Peyronie's disease in 1948 and thanks to its low cost and availability remains the most commonly prescribed oral agent for treatment of PD. Despite its use over the last seven decades, multiple placebo-controlled studies have not shown significant improvement in pain, degree of curvature, plaque size or restore erections. In 1983, Pryor and Farrell completed a double-blind, placebo-controlled study of vitamin E in 40 patients with PD and found no significant improvement in plaque size or penile curvature. In addition, a more recent study conducted in 2007, filed the largest study of vitamin E for treatment of Peyronie's disease. The authors compared vitamin E alone and in combination with L-carnitine with placebo in 236 men with early chronic PD; is classified as a patient with pain during erection, penile curvature not affecting vaginal penetration, painless palpabile scar, damage hyperechogenic with ultrasound of the penis, absence of calcification, and total plaque area <2 cm2.

Group 1 (58 men) received 300 mg vitamin E orally twice a day.

Group 2 (59 men) received propionyl-L-carnitine 1 g orally twice a day.

Group 3 (60 men) received 300 mg vitamin E orally twice a day, and 1 g of propionyl-L-carnitine orally twice a day.

Group 4 received a similar regimen of placebo during the 6-month probationary period. After therapy there was no significant change in reducing penile curvature among the four groups (P = 0,9), and also in reducing the size of plaques (P = 0.1) (12).

Ointment

Despite the lack of evidence supporting the effectiveness of vitamin E, it is still often prescribed prescribed along with other treatments with the hope of a synergistic role. Common side effects from the use of vitamin E include nausea, vomiting, diarrhea and an increased risk of developing prostate cancer.

Heparin ointment for Peyronie's disease

Heparin ointment reduces inflammation in the tissues of the penis, dilates blood vessels, thereby optimizing the hemodynamics.

Can be assigned for pain in acute phases. Therapeutic effect of ointment will not.

Omega-3 fatty acids

Omega 3 was tested with Peyronie's disease (due to anti-inflammatory properties)

In 2009 he published a study in a randomized, double blind study of omega-3 compared with placebo.

A total of 224 patients with early chronic PD were randomized to a dose of 1.84 g daily supplements of omega-3 compared with placebo for 6 months.

Unfortunately, there has been no significant improvement in plaque volume, penile curvature, pain during erection and erectile function. Currently, there are no data confirming the positive effects of omega-3 in the early chronic stages of Peyronie's disease.

Omega 3 is useful for any person. You can take omega 3 without prescription. But there was no treatment effect will be.

Omega 3

The phosphodiesterase type 5 inhibitors (inhibitors PDE-5)

Though inhibitors PDE-5 are generally regarded as the treatment of erectile dysfunction (ED), recent studies have shown its potential use in the treatment of Peyronie's disease in patients with or without ED. Inhibitors PDE5 increases cyclic guanosine-monophosphate (cGMP) by inhibiting the degradation of GMP to GMP. With the increase in the level of cGMP and NO synthesis and deposition of collagen are inhibited, and the apoptosis of fibroblasts and myo-fibroblasts.

Due to this property the inhibitors PDE-5 can be useful for remodeling scars.

At the moment, there was only one study that seemed to improve scar formations on the penis. But all patients were without significant plaques. And the curvature was less than 10%.

At the moment, PDE 5 is not assigned. Maybe later, when there will be new clinical trials and proven therapeutic effect.

L-arginine

L-arginine contributes to the reduction of fibroblasts for apoptosis. The mechanisms that underlie L-arginine is considered as an anti-fibrotic agent.

The researchers measured plaque in the penis in rats that received inhibitors of PDE-5, and l-arginine. Similar inhibitors of PDE-5, L-arginine showed a significant decrease in the size of plaques and the relationship of collagen to the fibroblast. Later research has shown that arginine also has a protective effect against the formation of scar tissue when exposed to the penis of rats.

In 2012, noted a trend towards improvement in curvature in patients with PD treated with therapy of the penis in combination with vnutricletocnam verapamil, oral L-arginine and oral pentoxifylline (PTX). Although this study has many variables that can contribute to improve curvature, it was one of the few human trials in which L-arginine was used to treat PD. Given these results, L-arginine may be a useful treatment option for BP, but further testing is needed on humans.

L-arginine

L-arginine can be assigned complex conservative therapy.

Peyronie's disease without surgery: local administration of drugs

This method is more effective in correcting curvature of the penis, rather than the use of oral resources. Injections are administered under local anesthesia. The procedure should only be carried out by an experienced technician.

Drugs are introduced into the tunica albuginea of the penis (directly into the plaque and scar). The procedure should be performed with extreme caution, as there is a big risk to aggravate the pathological process, increase inflammation, the number and size of plaques.

The possibility of treatment of injections depends on the size of the plaque, its location and General condition of the patient. If the injection is a long process, when surgical treatment of the curvature can be eliminated in one operation. On internal consultation to determine best treatment option for each patient.