Vitamin E

You may also see vitamin E listed by its chemical name, tocopherol. It is one of the oldest and most commonly prescribed treatments for Peyronie’s disease.

Vitamin E is a natural antioxidant. It is thought to inhibit scar tissue build-up and reduce inflammation.

Despite the lack of evidence for benefit, urologists commonly prescribe vitamin E when Peyronie’s disease is in the early, or active, phase. Doses over 400 IU per day are not recommended due to potential toxicity. Given the lack of evidence of benefit, the APDA Medical Advisory Board does not recommend vitamin E for the treatment of Peyronie’s disease.

References

1. Hellstrom WJG. Medical management of Peyronie’s disease. J Androl. 2009;30(4):397-405.
2. Jack GS, Gonzalez-Cadavid N, Rajfer J. Conservative management options for Peyronie’s disease. Curr Urol Rep. 2005;6:454-460.
3. Akin-Olugbade Y, Mulhall JP. The medical management of Peyronie’s disease. Nat Clin Pract Urol. 2007;4(2):95-103.
4. APDA Medical Advisory Board. Clinical experience.

Vitamin E

Potaba^®

Potaba (marketed by Glenwood, Englewood, NJ) is the brand name for potassium aminobenzoate. It is only available by prescription and is usually expensive.

Potaba is related to the B vitamins and is thought to interfere with plaque formation.

References

1. Hellstrom WJG. Medical management of Peyronie’s disease. J Androl. 2009;30(4):397-405.
2. Jack GS, Gonzalez-Cadavid N, Rajfer J. Conservative management options for Peyronie’s disease. Curr Urol Rep. 2005;6:454-460.
3. Akin-Olugbade Y, Mulhall JP. The medical management of Peyronie’s disease. Nat Clin Pract Urol. 2007;4(2):95-103.
4. Potaba product information. Glenwood; Englewood, NJ.
5. APDA Medical Advisory Board. Clinical experience.

Potaba^®

Colchicine

Colchicine has been approved for the treatment of gout. You may see it called by the brand name Colcrys^® (marketed by URL Pharma, Inc., Philadelphia, PA).

Colchicine decreases collagen production and increases the activity of collagenase, a naturally occurring enzyme that breaks down collagen.

References

1. Hellstrom WJG. Medical management of Peyronie’s disease. J Androl. 2009;30(4):397-405.
2. Jack GS, Gonzalez-Cadavid N, Rajfer J. Conservative management options for Peyronie’s disease. Curr Urol Rep. 2005;6:454-460.
3. Akin-Olugbade Y, Mulhall JP. The medical management of Peyronie’s disease. Nat Clin Pract Urol. 2007;4(2):95-103.
4. APDA Medical Advisory Board. Clinical experience.

Colchicine

Carnitine

Carnitine is a naturally occurring chemical found in most cells in the body. It is believed to restore cells damaged by inflammation and to help the healing process.

References

1. Hellstrom WJG. Medical management of Peyronie’s disease. J Androl. 2009;30(4):397-405.
2. Jack GS, Gonzalez-Cadavid N, Rajfer J. Conservative management options for Peyronie’s disease. Curr Urol Rep. 2005;6:454-460.
3. Akin-Olugbade Y, Mulhall JP. The medical management of Peyronie’s disease. Nat Clin Pract Urol. 2007;4(2):95-103.
4. Bella AJ, Perelman MA, Brant WO, Lue TF. Peyronie’s disease. J Sex Med. 2007;4:1527-1538.
5. APDA Medical Advisory Board. Clinical experience.

Carnitine

Tamoxifen

Tamoxifen has been approved by the Food and Drug Administration for the treatment or prevention of breast cancer. It is only available by prescription.

It is thought to inhibit inflammation responses in Peyronie’s disease.

References

1. Hellstrom WJG. Medical management of Peyronie’s disease. J Androl. 2009;30(4):397-405.
2. Jack GS, Gonzalez-Cadavid N, Rajfer J. Conservative management options for Peyronie’s disease. Curr Urol Rep. 2005;6:454-460.
3. Akin-Olugbade Y, Mulhall JP. The medical management of Peyronie’s disease. Nat Clin Pract Urol. 2007;4(2):95-103.
4. APDA Medical Advisory Board. Clinical experience.

Tamoxifen

L-Arginine

L-Arginine is a naturally occurring amino acid. and is believed to prevent scarring. There is no evidence that L-Arginine can reverse a scar that has already formed.

References

1. APDA Medical Advisory Board. Clinical experience.

L-Arginine

Pentoxifylline

It is available by prescription as a generic or under the brand name Trental^® (marketed by Sanofi-Aventis, Bridgewater, NJ). It is approved to improve blood flow through the body in patients with circulation problems.

Pentoxifylline is thought to work in a way that is similar to L-arginine and may prevent scarring.

References

1. Bella AJ, Perelman MA, Brant WO, Lue TF. Peyronie’s disease. J Sex Med. 2007;4:1527-1538.
2. APDA Medical Advisory Board. Clinical experience.

Pentoxifylline

Verapamil

Verapamil is used by many urologists for treating Peyronie’s disease. It is a calcium channel blocker that is available in tablet, injectable, and gel forms. It has already been approved for treating high blood pressure or irregular heartbeats.

The injectable and gel forms have been studied in Peyronie’s disease. They prevent scar formation and increase the breakdown of collagen in existing scar tissue.

References

1. Hellstrom WJG. Medical management of Peyronie’s disease. J Androl. 2009;30(4):397-405.
2. Bella AJ, Perelman MA, Brant WO, Lue TF. Peyronie’s disease. J Sex Med. 2007;4:1527-1538.
3. APDA Medical Advisory Board. Clinical experience.

Verapamil

Corticosteroids

Corticosteroids, such as dexamethasone, have been tried for Peyronie’s disease because they reduce inflammation.

References

1. Hellstrom WJG. Medical management of Peyronie’s disease. J Androl. 2009;30(4):397-405.
2. Jack GS, Gonzalez-Cadavid N, Rajfer J. Conservative management options for Peyronie’s disease. Curr Urol Rep. 2005;6:454-460.
3. Akin-Olugbade Y, Mulhall JP. The medical management of Peyronie’s disease. Nat Clin Pract Urol. 2007;4(2):95-103.

Corticosteroids

Interferon alpha

Interferons are produced naturally by the body and regulate the immune system. There are several types.

In Peyronie’s disease, interferon alpha reduces the production of collagen, one of the main components of the plaque. You may see this medicine as the brand name Intron^® A (marketed by Schering Corporation, a subsidiary of Merck & Co, Whitehouse Station, NJ).

References

1. Hellstrom WJG. Medical management of Peyronie’s disease. J Androl. 2009;30(4):397-405.
2. Jack GS, Gonzalez-Cadavid N, Rajfer J. Conservative management options for Peyronie’s disease. Curr Urol Rep. 2005;6:454-460.
3. Akin-Olugbade Y, Mulhall JP. The medical management of Peyronie’s disease. Nat Clin Pract Urol. 2007;4(2):95-103.
4. APDA Medical Advisory Board. Clinical experience.

Interferon alpha

Vacuum pumps

Vacuum pumps are based on the rationale that tension may encourage the scar tissue in the penis to be reconstructed, leading to a reduction in curvature. Available brands include the Osbon ErecAid^® (manufactured by MediPlus, High Wycombe, UK).

Vacuum pumps are made up of tube that fits over the penis. A mechanism removes air from the tube and applies gentle stretching tension to the penis.

References

1. Raheem AA, Garaffa G, Raheem TA, et al. The role of vacuum pump therapy to mechanically straighten the penis in Peyronie’s disease. BJUI. 2009;1-3.
2. APDA Medical Advisory Board. Clinical experience.

Vacuum pumps

Penile extenders / traction therapy

Penis extender devices (also called traction devices) are based on the rationale that tension from stretching may lead to a reduction in curvature. Available brands include the X4 Extender Peyronie’s Edition (manufactured by X4 Labs™, Montreal, Canada) and Andropenis (manufactured by Andromedical, Madrid, Spain).

Extender devices are made up of a plastic ring that fits around the end of the penis attached to 2 movable metal rods that apply tension outward by putting pressure on a plastic support that rests against the body.

References

1. Levine LA, Newell M, Taylor FL. Penile traction therapy for treatment of Peyronie’s disease: a single-center pilot study. J Sex Med. 2008;5:1468-1473.
2. Gontero P, DiMarco M, Giubilei G, et al. Use of penile extender device in the treatment of penile curvature as a results of Peyronie’s disease. Results of a phase II prospective study. J Sex Med. 2009;6:558-566.
3. APDA Medical Advisory Board. Clinical experience.

Penile extenders / traction therapy

Electroshock
wave therapy

Electroshock wave therapy is also called extracorporeal shock wave therapy (ESWT). It is thought to break up the plaque by causing trauma and triggering the healing process.

This treatment may damage the plaque and penile tissues and may cause additional scarring.

References

1. Jack GS, Gonzalez-Cadavid N, Rajfer J. Conservative management options for Peyronie’s disease. Curr Urol Rep. 2005;6:454-460.
2. Akin-Olugbade Y, Mulhall JP. The medical management of Peyronie’s disease. Nat Clin Pract Urol. 2007;4(2):95-103.
3. Bella AJ, Perelman MA, Brant WO, Lue TF. Peyronie’s disease. J Sex Med. 2007;4:1527-1538.
4. APDA Medical Advisory Board. Clinical experience.

Electroshock
wave therapy

Iontophoresis

Iontophoresis is a painless, noninvasive procedure that involves applying small amounts of electrical current to the skin over a Peyronie’s plaque. It is also sometimes called electromotive drug administration (EMDA) or transdermal electromotive administration (TEA).

Iontophoresis may help medications penetrate the skin to the plaque area. It may also stimulate a healing process.

References

1. Hellstrom WJG. Medical management of Peyronie’s disease. J Androl. 2009;30(4):397-405.
2. Greenfield JM, Shah SJ, Levine LA. Verapamil versus saline in electromotive drug administration for Peyronie’s disease: a double-blind, placebo controlled trial. J Urol. 2007;177:642-975.
3. Akin-Olugbade Y, Mulhall JP. The medical management of Peyronie’s disease. Nat Clin Pract Urol. 2007;4(2):95-103.
4. Tuygun C, Ozok UH, Gucuk, et al. The effectiveness of transdermal electromotive administration with verapamil and dexamethasone in the treatment of Peyronie’s disease. Int Urol Nephrol. 2009;41:113-118.
5. DiStasi SM, Giannantoni A, Stephen RL, et al. A prospective, randomized study using transdermal electromotive administration of verapamil and dexamethasone for Peyronie’s disease. J Urol. 2004;171:1605-1608.
6. APDA Medical Advisory Board. Clinical experience.

Iontophoresis

Plication

Surgical treatment should only be considered on the advice of an experienced and knowledgeable physician.

Plication may be an appropriate surgical option for men who have curvature that is not severe, no hourglass deformity, and good erectile function. It is sometimes called the Nesbit procedure.

References

1. Kumar R, Nehra A. Surgical and minimally invasive treatments for Peyronie’s disease. Curr Opin Urol. 2009;19:589-594.
2. Bella AJ, Perelman MA, Brant WO, Lue TF. Peyronie’s disease. J Sex Med. 2007;4:1527-1538.
3. APDA Medical Advisory Board. Clinical experience.

Plication

Grafting

Surgical treatment should only be considered on the advice of an experienced and knowledgeable physician.

Grafting procedures may be appropriate for men who have good erection quality but have severe curvature and/or narrowing that causes buckling.

References

1. Kumar R, Nehra A. Surgical and minimally invasive treatments for Peyronie’s disease. Curr Opin Urol. 2009;19:589-594.
2. Bella AJ, Perelman MA, Brant WO, Lue TF. Peyronie’s disease. J Sex Med. 2007;4:1527-1538.
3. APDA Medical Advisory Board. Clinical experience.

Grafting

Implants

Surgical treatment should only be considered on the advice of an experienced and knowledgeable physician.

Many urologists reserve implant procedures as a last treatment option for men with Peyronie’s disease who also have erectile dysfunction or who have extensive plaques.

References

1. Kumar R, Nehra A. Surgical and minimally invasive treatments for Peyronie’s disease. Curr Opin Urol. 2009;19:589-594.
2. Bella AJ, Perelman MA, Brant WO, Lue TF. Peyronie’s disease. J Sex Med. 2007;4:1527-1538.
3. Levine LA, Benson J, Hoover C. Inflatable penile prosthesis placement in men with Peyronie’s disease and drug-resistant erectile dysfunction: a single-center study. J Sex Med. 2010; epub ahead of print.
4. APDA Medical Advisory Board. Clinical experience.

Implants

Collagenase

Collagenase, under the brand name Xiaflex (marketed by Auxilium Pharmaceuticals), is already approved for treating Dupuytren’s contracture, a condition that, like Peyronie’s disease, involves an abnormal build-up of collagen.

It is not yet approved for treating Peyronie’s disease, but shows promise in early clinical trials.

Collagenase breaks down the collagen that makes up the Peyronie’s plaque.

References

1. National Institutes of Health. ClinicalTrials.gov. Available at: http://clinicaltrials.gov.
2. APDA Medical Advisory Board. Clinical experience.

Collagenase

Botox^®

Botox contains botulinum toxin type A. It is being studied at a potential treatment for Peyronie’s disease by researchers at Baylor College of Medicine (Houston, TX) in collaboration with Allergan, Inc. Botox is already approved for treating a variety of conditions, including chronic migraines, certain muscle problems, and cosmetic facial concerns.

It is not yet approved for treating Peyronie’s disease.

Botox is injected into muscles, where it reduces muscle activity in the area near the injection.

References

1. National Institutes of Health. ClinicalTrials.gov. Available at: http://clinicaltrials.gov.
2. Botox (onabotulinumtoxin A) Prescribing Information. Irvine, CA: Allergan, Inc. April 2011.

Botox^®