In one of your answers you say the following: “Indeed, if treatment is started early it may prevent progression of the condition and may result in less length loss.” So taking a typical case of a lump in the middle causing an upward bend in the penis, what exactly would you use as “treatment” that is recommended early on and what is early?

Dr. Mulhall answers: There is great debate about this, but most authorities would recommend that the man use some form of treatment in an attempt to prevent progression. As mentioned in response to other questions, there is no data that transdermal therapies are of any benefit so they are not used in my practice. ESWT has no safety data and has mixed success rates to date, so this is not offered to patients. The mainstays of treatment in my practice are intralesional verapamil (ILV) and oral colchicines. The latter is typically reserved for men who do not wish to try ILV or are not candidates for this (such as men with certain cardiac conditions and men with ventral plaques). In my practice only 12% of men over the first 12 months get better without any treatment. This figure varies from practice to practice depending how closely men are monitored and how curvature is measured. As mentioned in in Dr. Mulhall’s article on How to Choose a Physician for Peyronie’s Disease if you are told that nothing can be done and that you should return in 6 months without discussing any treatment then you may need to consider a second opinion.