I am in physical therapy and want to do ultrasound for treatment of Peyronie’s. What is the protocol, I have forgotten since school how many w/cm2 and what intensity to use. Also, do you use pulse or continuous ultrasound?

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Various forms of external energy have been used to treat PD in non-randomized trials including topical ultrasound and lasers. The mechanism is unknown, but it has been suggested that ultrasound and laser treatment may enhance tissue healing. I am not familiar with any studies which have demonstrated any benefit with ultrasound or laser and therefore, cannot speak to the specific modality or energy level that should be used for ultrasound treatment of Peyronie’s disease. One treatment that has gained some attention in Europe and recently in the U.S. is iontophoresis or electromotive drug administration (EMDA). This treatment provides electric current to drive drugs through the skin into the underlying scar tissue. Studies have shown that EMDA can indeed drive verapamil into the plaque tissue and therefore may make some sense. More recent studies have suggested that the combination of verapamil and dexamethasone may provide the best outcomes with regard to improvement of deformity and rapid reduction of pain. But, the overall reduction of curvature tends to be small, in the 10-30 degree range. In my opinion, iontophoresis would be useful in the patients with mild to moderate curvature only or those who also have significant pain, as the EMDA treatment does seem to result in rapid resolution of the pain.

Previous I am a sixty-four year old white male living in the United Kingdom, six foot tall, twelve and a half stone in weight and I consider myself to be in good health. I am not on any medication; I exercise regularly, sleep well, eat healthily and had a good sex-life with my partner. At the end of March 2013 I was diagnosed with Peyronie’s Disease. I have been offered a course of ESWT (Extracorporeal shock wave therapy). My question: This procedure ESWT, how effective is it in treating Peyronie’s Disease, is it too early to do this procedure as it is only been six/seven months since the disease first started and how safe is the ESWT procedure? Many thanks for all the information the association has published, it has helped me enormously to come to terms with the disease.
Next 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?
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