Non-Surgical Treatment of Peyronie’s Disease: A Comprehensive Review

Chernylovskyi, Volodymyr A.; Krakhotkin, D.V.; Chaikovskyi, V.

doi:10.36740/wlek202103129

Cited by 2 publications

(4 citation statements)

References 79 publications

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“…There was no significant benefit demonstrated when assessing plaque size, pain or penile length. This is in keeping with another recent review which included observational studies as well [ 73 ]. Interestingly many observational “real world” post-approval studies [ 74 – 76 ] have shown intralesional CCH to be of benefit in acute phases of PD, but these findings are yet to be confirmed in RCTs.…”

Section: Discussionsupporting

confidence: 88%

“…Although there is enormous interest in non-surgical treatment options of PD, there is still a paucity of data from large, well conducted randomised trials within the literature. Other reviews [ 73 , 80 , 81 ] of the literature have focused only on selected non-surgical treatments or have included studies other than randomised trials resulting in a varied and inconclusive evidence based which has at times conflicted with our findings. This systematic review provides the most up-to date and extensive summary of all non-surgical treatments for PD, including only high-quality randomised trials.…”

Section: Discussionmentioning

confidence: 80%

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A systematic review of non-surgical management in Peyronieʼs disease

et al. 2022

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The efficacy of many non-surgical treatments for Peyronie’s disease is unclear. This systematic review aims to critically assess the currently available options and provide a recommendation for treatment based on this. A systematic literature search utilising the Medline (Pubmed), Embase, global health and Cochrane library databases was conducted up to May 2021. All randomised controlled trials assessing non-surgical treatment modalities for Peyronie’s Disease were included. Individual study risk of bias was evaluated using the Cochrane tool and GRADE was used to assess evidence strength. Outcome measures were the change in penile curvature (degrees), plaque size (volume or size), International Index of Erectile Function score, pain scores and change in penile length. Prospero registration number: CRD42017064618. Amongst the 5549 articles identified, 41 studies (42 reports) were included. Seven different oral treatment options including vitamin E supplementation showed evidence for improving outcomes such as penile curvature and plaque size. Of the intralesional treatments, Collagenase Clostridium Histolyticum showed evidence for improving penile curvature (Range: 16.3–17 degrees, moderate level certainty of evidence). Intralesional Interferon demonstrated some improvement in curvature (Range: 12–13.5 degrees), plaque size (Range: 1.67–2.2 cm2) and pain, whilst intralesional calcium channel blockers such as Verapamil showed variable evidence for changes in the plaque size and pain. Extracorporeal Shockwave Therapy consistently demonstrated evidence for improving penile pain in stable disease, and two mechanical traction devices improved curvature. Iontophoresis, topical medications, and combination therapies did not demonstrate any consistent improvements in outcome measures. Intralesional options demonstrate the best potential. Overall, results varied with few high-quality randomised trials present.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 80%

A systematic review of non-surgical management in Peyronieʼs disease

et al. 2022

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“…82 It is said that PTT enhances the functioning of collagenases and metalloproteinases. 83 In recent years, PTT has been used in PD patients regardless of the disease phase. 84 In a prospective, non-blinded trial, 55 patients undergoing PTT in the acute phase of PD were compared with 41 patients in a control group.…”

Section: Penile Traction Therapymentioning

confidence: 99%

“…PTT uses mechanical force to elongate the phallus and boost mechanotransduction, leading to the modification of the extracellular matrix, which impacts cell apoptosis and proliferation 82 . It is said that PTT enhances the functioning of collagenases and metalloproteinases 83 . In recent years, PTT has been used in PD patients regardless of the disease phase 84 …”

Section: Physical Therapymentioning

confidence: 99%

Current trends in non‐surgical management of Peyronie's disease—A narrative review

Kozub,

Suleja,

Chłosta

et al. 2023

Andrology

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Peyronie's disease (PD) is a connective tissue disorder affecting the tunica albuginea. It can cause pain and penile deformation, and its prevalence increases with age. Although surgery is the gold standard for the chronic phase of the disease, there are several conservative treatment methods available, and the optimal management of the acute phase of the disease remains a matter of debate. In this article, we aim to summarize the recent trends in research on the subject of non‐surgical treatment of PD. The search was performed in PubMed, Scopus, and Web of Science databases and included studies in English published between 2012 and 2022 investigating the clinical outcomes of non‐surgical PD management in humans. We have identified 20 distinct conservative treatment strategies. Among the oral therapeutics, only the use of phosphodiesterase type 5 inhibitors is currently recommended for clinical use in patients with concomitant erectile dysfunction. The use of collagenase from Clostridium histolyticum is supported by the best quality evidence in terms of intralesional injections for patients suffering from significant penile curvature; however, interferon alpha‐2b can also be an option in such patients. Among other non‐invasive methods, extracorporeal shockwaves can be useful for pain reduction, and penile traction therapy can lead to a reduction in penile curvature and plaque size. Despite a wide range of non‐surgical methods available for PD treatment, the majority are not supported by sufficient scientific evidence, and the treatment efficacy is underwhelming. Further research on the subject of non‐surgical management of PD is highly warranted.

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Non-Surgical Treatment of Peyronie’s Disease: A Comprehensive Review

Cited by 2 publications

References 79 publications

A systematic review of non-surgical management in Peyronieʼs disease

A systematic review of non-surgical management in Peyronieʼs disease

Current trends in non‐surgical management of Peyronie's disease—A narrative review

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