I first noticed my symptoms only about 3 months ago (painful erections, hard nodule under the skin when flaccid) and am currently in the “active” phase of the disease. Is there anything I should or should not be doing during this phase in order to minimize the eventual resulting curvature? It’s only slightly noticeable (approx. 5-10%) and I’d like it to stay that way.

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Dr. Levine answers: It’s true that you are currently in the active phase. Contemporary natural history studies have suggested that during the “active” phase, 50% of patients will have worsening of their deformity, around 40% will stay the same and less than 10% will have spontaneous resolution of curvature. Therefore, you are at risk to have progression of your Peyronie’s, but given that it is so slight at this time, it may not progress. Avoiding vigorous gymnastics during sexual activity would be beneficial as well as avoiding female on top/ “rodeo sex” where the pressures on the penis can be quite substantial and may further activate the scarring process. It is reasonable to continue sexual activity, but just be careful. For men who have mild deformity and no significant pain but are interested in doing something short of injection therapy or iontophoresis, I have recommended the combination of pentoxifylline 400 mg two times a day which is a generic prescription drug, and L-arginine 500 mg two times per day. It is reasonable to continue on this treatment for three months. This therapy is best prescribed by a urologist who will provide an initial evaluation and then will be able to track your progress over time.

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