Review of current nonsurgical management of Peyronie's disease

Levine, Laurence A.

doi:10.1038/sj.ijir.3901084

Cited by 32 publications

(16 citation statements)

References 34 publications

(36 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We think vitamin E is more effective when it is combined with other drugs, but this consideration should be also made to any substance in the medical management of PD. Our findings confirm that the best approach for treating PD is multimodal therapy (Levine, 2003;Lemourt Oliva et al, 2005;Mirone, 2007;Taylor & Levine, 2008;Cortés-Gonzá-lez & Glina, 2010;Kuehhas et al, 2011;Abern et al, 2012;Cavallini et al, 2012) because it was able to achieve greater results than each single drug alone. At the end of the treatment (6 months), for each patient we have planned 1 year of conservative treatment, until the stabilization of disease.…”

Section: Discussionsupporting

confidence: 76%

Efficacy of vitamin E in the conservative treatment of Peyronie's disease: legend or reality? A controlled study of 70 cases

et al. 2012

View full text Add to dashboard Cite

SUMMARYThe medical treatment is indicated in the development stage of Peyronie's disease (PD) for at least 1 year after diagnosis and whenever in case of penile pain. This research was conducted to demonstrate the possible effectiveness of vitamin E in PD treatment, whereas in the scientific literature this topic is much discussed. A total of 70 patients (age:26-69 years, mean: 54.1 ± 9.71) diagnosed with PD were enrolled in a conservative treatment. In addition to medical histories and physical examinations all patients underwent the following tests: International Index of Erectile Function (IIEF) questionnaire, penile ultrasound and photographic documentation, pain evaluation by a conventional 10-point pain scale Visual analogue pain scale (VAS). All 70 patients were divided into two different treatment groups: A and B, with different combinations of drugs: A = vitamin E + verapamil (injection + iontophoresis) + blueberries + propolis + topical diclofenac; B = verapamil (injection + iontophoresis) + blueberries + propolis + topical diclofenac. All patients were treated for 6 months after which they underwent the same follow-up tests as performed prior to the treatment. Intergroup analysis revealed statistically significant differences: in the vitamin E group the effective plaque size reduction was À50.2% whereas in the control group the reduction was À35.8% (p = 0.027). In group A the improvement of curvature occurred in 96.6% of the cases whereas in the control group B this occurred in 48.4% (p = 0.0001), moreover, the mean curvature decrease was respectively À12.25°and À6.73°(p = 0.01). IIEF score was significantly improved in group A patients with comorbidities and erectile dysfunction (p = 0.025). Increase in plaque size occurred only in the control group (17.1%) (p = 0.032). We can affirm that vitamin E can help to prevent the progression of PD. This study strongly supports the recommendation that the best approach for treating PD is multimodal therapy.

show abstract

Section: Discussionsupporting

confidence: 76%

Efficacy of vitamin E in the conservative treatment of Peyronie's disease: legend or reality? A controlled study of 70 cases

et al. 2012

View full text Add to dashboard Cite

show abstract

“…But in 1975, Winter and Khanna reported no difference between patients treated with dexamethasone and those who remained untreated. Currently, treatment of PD with intralesional steroids is cautioned because of local side effects (ie, atrophy or fibrosis mainly with repeated injections) and the inconsistent pattern of improvement in well‐established curvature (Levine, 2003). However, use of steroid injections in the management of penile pain has been poorly investigated to date.…”

Section: Discussionmentioning

confidence: 99%

Severe, Disabling, and/or Chronic Penile Pain Associated With Peyronie Disease: Management With Subcutaneous Steroid Injection

Dickstein

Uberoi

Munárriz

2010

Journal of Andrology

View full text Add to dashboard Cite

: Penile pain is one of the most distressing, limiting, and difficult to treat manifestations of Peyronie disease. The use of steroid injections for penile deformities associated with Peyronie disease has been ineffective. However, use of steroid injections in managing penile pain has been poorly investigated. The aim of this study was to examine the efficacy and safety of subcutaneous, nonintralesional steroid injections in patients with severe, disabling, and/or chronic penile pain associated with Peyronie disease. This was a single‐institution retrospective study of 16 patients with severe, disabling, and/or chronic penile pain associated with Peyronie disease who underwent subcutaneous, nonintralesional injection of triamcinolone (50 mg) between 2004 and 2006. Preinjection and postinjection analog pain scales were used to assess treatment efficacy. All 16 patients (mean age, 47.6 ± 11.1 years) had penile pain associated with erections for an average of 13.9 months (range, 3–36 months) prior to injections. Mean preinjection and postinjection penile pain scores were 6.6 ± 2.1 and 0.5 ± 0.5, respectively. On average, patients were pain free at follow‐up visits within 10.6 ± 7.6 weeks. The mean pain‐free duration was 23.8 months (range, 3–52 months). The mean cumulative dose of triamcinolone was 75.0 mg (range, 50–200 mg), with a mean of 1.5 injections (range, 1–4 injections). All 16 patients had overall improvement in pain scores. There were no adverse events or geometric penile changes after injections. Subcutaneous, nonintralesional injections of triamcinolone is an effective, safe, and durable means of managing severe, disabling, and/or chronic penile pain in patients with Peyronie disease. Future studies are needed to validate these findings.

show abstract

“…Various hypotheses about its mechanism of action exist, including direct damage to the plaque, resulting in an inflammatory reaction with increased macrophage activity leading to plaque lysis, improved vascularity resulting in plaque resorption, and the creation of contralateral scarring of the penis resulting in 'false' straightening. 73 Hauck et al 74 randomized 43 men to ESWT or oral placebo for 6 months. No significant effect was noted in terms of curvature, plaque size or subjective improvement in sexual function or rigidity.…”

Section: Penile Electroshock Wave Therapy (Eswt)mentioning

confidence: 99%