The treatment of penile deformity, penile shortening, penile pain and the associated erectile dysfunction is part of our major focus. Peyronie’s disease is very common affecting up to 10.9% of men with incidence increasing with age. This is an inflammatory – fibrotic process of the erectile bodies of the penis, often developing between the ages of 40 to 60 years. Such issues usually present as penile curvature-deformity, penile pain on erection, penile shortening and increasing erectile dysfunction. Almost always the end result is a persistent, painful deformity that interferes with sexual relations. Some, or all, of these problems can occur together and should be evaluated by a Urologist who is not only specialized in the treatment of ED (Erectile Dysfunction), but also has expertise in this specific area of sub-specialization.
Almost always there is an optimal solution. Treatment selection depends upon the extent and severity of the curvature, the amount of shortening, the severity of the pain and the degree of the ED. Surgery is seldom necessary. Treatment can almost always be done in the office setting. Usually there is one best treatment plan that incorporates a combination of the following choices.
The complete range of treatment options is available:
- Xiaflex (collagenase clostridium hystiolyticum) — an enzyme that dismantles collagen
- FDA-approved and performed via penile injection (can use local anesthetic if required)
- Safe if all precautions and specific protocol is followed
- Very effective … the main component in avoiding surgery
- Penile traction device
- Many makes/models available but RestoreX is by far the most effective
- Enhanced effectiveness when used consistently and in combination with other treatments
- LI-ESWT (Low Intensity Extracorporeal Shock Wave Therapy)
- Treatment is safe and is an office procedure and can be used in conjunction with, and also enhances, other treatments
- FDA-approved off label (and can be used even if anticoagulated)
- Over 79% effective in improving erectile dysfunction but also can significantly improve the nature of the Peyronie’s tissue changes
- Success appears to be directly related to the experience, and skill, of the person treating where in our office this part of the treatment is only performed by the Urologist
- The preferred device used the Spark Wave (Urogold 100) designed by the maker of Shock Wave therapy devices for the treatment of kidney stones and felt to be the best available device
- Note: Please avoid acoustic or radiofrequency treatments which are popular but ineffective. Many of the machines currently marketed are ballistic radial devices: EPAT (Extracorporeal Pulse Activation Technology) and (RSWT) Radial Shockwave Therapy and do not produce a true medical shockwave according to the (ISMT) International Society for Medical Shockwave Treatment
- P-Shot (also called a Priapus shot)
- Uses the patient’s own activated platelet rich plasma
- Office-based procedure where platelets are extracted from the patient’s blood then activated and safely re-injected into the penis
- Helps in resolving the Peyronie’s plaques and deformity and at the same time usually improves both blood flow, erectile function and sensation
Although these treatment options are effective independently, the correct combination usually maximizes the improvement that can be achieved. We understand the anxiety, frustration and discouragement that can be associated. Even though these problems seem insurmountable, our expertise and experience will allow us to formulate an optimal treatment plan and to achieve a satisfactory resolution.