Nonsurgical Treatment

I am 23 years old and having treatment of peyronies’s disease applying verapamil gel as prescribed by doctor since 4 months. I still masturbate almost twice a week. Will this make my condition worse?

There is no evidence that application of verapamil gel has any benefit whatsoever, I would advise saving your money and not using this approach at all. As to the question regarding masturbation, if masturbation causes pain, then it should be adjusted or stopped as this may be

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I am looking for the best medical therapy for a moderate Peyronie’s case (no ED, age 30, healthy) and have questions about a combination Dr. Levine once proposed (PDE5 e.g. Sildenafil 25mg daily, L-arginine 500 mg twice daily, pentoxyfiline 400 mg thrice daily). 1. L-Arginine is known to be a precursor to nitric oxide. Why is that not contraindicated with Sildenafil (“no nitrics”) 2. Pentox says it should not be combined with substances that lower the blood pressure. Any problem with Sildenafil?

At this time, there is no FDA approved, non-surgical treatment for Peyronie’s disease, but several treatment options have been proposed, Dr. Levine’s three-armed, non surgical therapy includes pentoxifylline 400mg 3 times per day, L-arginine 1000mg twice per day, or L-citrulline 750mg twice daily. The second arm includes

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What is your opinion on the use of intralesional verapamil for young patients who have had the disease for over three years, but have little or no calcification in the plaque? If it is sensible to try verapamil, would it be better to use iontophoresis? Would traction therapy further enhance the benefits?

Dr. Levine answers: Intralesional verapamil remains as the most commonly used injection approach for Peyronie’s disease and appears to have fairly consistent results with respect to response. Overall, between 50-60% of men who complete a course of intralesional verapamil will have measured improvement of curvature. “Measured improvement”

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How do patients who have curvatures of the penis greater than 30 degrees do when the curvature involves just the distal end of the penis? Can it correct itself without treatment? What about vitamin E? Do we typically see worsening of the disease after a period of 12-18 months?

Dr. Levine answers: This question addresses many issues in Peyronie’s disease, first that Peyronie’s disease can present with a variety of deformities anywhere along the shaft of the penis and there is nothing particularly unique with respect to treatment response about the curvatures which occur at the

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I am 45, Peyronie’s for 5 years, stable, curve about 75 degrees. I am able to have sexual intercourse, but I worry about getting worse over time. My urologist suggests I take 2 Pentox a day, Is this OK or should I take 3? I also worry about being on the Pentox for years, if I quit after one year will I experience any worsening? Will using Pentox mess with my Immune system? I suffer from lower than normal testosterone, so I get sick easily. Should vitamin D be taken with Pentox to help in immunity?

Dr. Mulhall answers: Firstly, at 5 years the likelihood of your PD worsening is practically zero unless you re-injure your penis. There is no good evidence that Pentox is of significant benefit, although many experts use it because of some experimental (nonhuman) evidence that it has a

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There have been 2 recent studies done on the effectiveness of traction devices at reducing curvature. Paolo Gontero, et al reported an average curvature reduction of 4 degrees. Levine, et al reported an average curvature reduction of 15 degrees. The duration of both studies was 6 months and the hours of use per day was similar. What accounts for the large difference in results between the 2 studies?

Dr. Mulhall answers: It is important for readers of this site to understand that I have no association or financial involvement with FastSize. To summarize the role of traction therapy for PD, firstly there exists some experimental evidence that chronic stretching of scars softens the scar and

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I am 65 and was diagnosed with PD 18 months ago. I have a 50-degree upward curvature and some associated erectile dysfunction, but with Viagra I am still able to be sexually active. I plan to purchase the Fastsize Extender and use it in conjunction with L-arginine in hopes of reducing the degree of curvature. Is there a problem using L-argenine and Viagra together?

Dr. Levine answers: As you know, erectile dysfunction (ED) frequently accompanies Peyronie’s disease and in fact up to 90% of patients have been reported some reduction of rigidity. The use of all three of the PDE-5 inhibitors (i.e. Viagra, Levitra, and Cialis) have been used successfully to

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Peyrontin has been offered as an oral cure for Peyronie’s disease. Has there been any research done on it? Is there any other recent research done on oral treatments?

Dr. Levine answers: I am not familiar with Peyrontin and in general there have been no placebo controlled trials that have shown a benefit to using any oral agent over taking a placebo pill. This includes vitamin E, Potaba (other than reducing the plaque size), colchicine, tamoxifen,

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Many Peyronie’s suffers use traction devices to straighten their penises. Do many use jelqing for straightening?

Dr. Mulhall answers: As a scientist who has devoted more than a decade to the laboratory and clinical research in men with PD, I am very comfortable stating that there is no data that jelqing is of ANY benefit to men with PD. Indeed, I have seen

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A naturopathic doctor also recommends L-arginine for PD, but insists that a low dose will do nothing. No, he is not selling L-arginine. He recommends a very high dose — at least 3 grams per day and working up to 21 grams per day. Do you know of any risks to trying this?

Firstly, there is no convincing evidence that any dose of L-arginine is of any benefit for the stabilization or reversal of PD associated penile curvature. Saying that, it is a very safe agent so high doses as outlined by the other clinician is likely to cause you

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