Conservative treatment of Peyronie's disease

Conservative treatment of Peyronie's disease possible in the acute phase, at the initial stage. The pills, injections may relieve the pain, not inflammation. To get rid of the external signs of the curvature of the member states is possible only with injection of the plaque, or surgically.

Peyronie's Disease

The first symptoms of penile curvature, it is necessary to ask for professional help. The doctor andrologist and select for you the optimal solution to the problem. After the diagnosis, maybe the meet the conservative therapy.

How to cure Peyronie's disease without surgery: principles of therapy

The principles, goals in the conservative treatment of Peyronie's disease, or:

  • the removal of the acute inflammatory process, reduces the field intensity in the tunica albuginea of the penis;
  • reduction of pain syndrome;
  • preventing the formation of plaques;
  • the decrease in the area or (if possible) the complete dissolution of the plaque;
  • it may be necessary for a conservative treatment of Peyronie's in the postoperative period .

Perhaps the use of physiotherapy, oral medications, topical treatments, injectable treatment. To cure Peyronie's disease in the early stages it can only help the complex therapy, which includes different approaches.

Drugs for the treatment of Peyronie's disease

Many drugs that have passed clinical trials and is effective in Peyronie's disease. All of them provide the effects, while focused on different stages of pathogenesis, which requires the integrated application.

Only if the internal examination, Doppler ultrasound of the penis doctor may suggest the type of treatment can be effective (a lot depends on the causes of the disease).

Treatment of Peyronie's disease without surgery paraaminobenzoic

This medicine is a number of beneficial therapeutic effects:

  • inhibits proliferation of fibroblasts;
  • reduces the secretion of mucopolysaccharides, glycosaminoglycans;
  • increase the absorption of the oxygen, the tissues of the penis;
  • inhibits fibrinogenez.
Injection

Injection

Is indicated in adult men with Peyronie's disease with a palpable plaque and curvature deformity of at least 30 degrees at the beginning of therapy. Injection directly into the plaque. Each injection helps to reduce and destroy plaque and keep the curvature of the penis, called Peyronie's disease.

Vitamin E for Peyronie's disease

Vitamin E is a fat-soluble antioxidant that disarms the free radicals, which are saturated with nitrogen oxide (NO), thereby maintaining a high level of active, the NOT-proper healing. Limit the oxidative stress is also a potential anti-inflammatory effect. This was the first description of the treatment of Peyronie's disease in 1948 and thanks to the low cost, availability remains the most commonly prescribed oral agent for the treatment of the POLICE. Despite the fact that the use of the past seven decades, more placebo-controlled trials have not shown a significant improvement in the pain, degree of curvature, plaque size or restore erections. In 1983, Pryor and Farrell finished with a double-blind, placebo-controlled study of vitamin E in 40 patients with PD but found no significant improvement in plaque size or curvature of the penis. In addition, another study in 2007, provided the largest study of vitamin E treatment for Peyronie's disease. The authors compared vitamin E alone and in combination with L-carnitine placebo in 236 men with early chronic PD; quality of the patient's pain during erection, penile curvature not affecting vaginal penetration, pain-free palpabile wound, injury hyperechogenic ultrasound of the penis, absence of calcification, and total area of plaques <2 cm2.

1. group (58-year-old men) received 300 mg vitamin E orally twice daily.

2. group (59 men) received propionyl-L-carnitine 1 g orally twice a day.

3. group (60 men) received 300 mg vitamin E orally twice daily, 1 g of propionyl-L-carnitine orally twice daily.

4. group received a similar placebo treatment during the 6 month probationary period. After the treatment there was no significant change to reduce the penile curvature among the four groups (P = 0,9), and reduces the size of plaques (P = 0.1) (12).

Ointment

Despite the fact that there is no evidence supporting the effectiveness of vitamin E, it is still often prescribed prescribed and other treatments, the hope, the synergistic role. Common side effects when using vitamin E include nausea, vomiting, diarrhea, increased risk of prostate cancer.

Heparin ointment for Peyronie's disease

Heparin ointment reduces inflammation, in the tissues of the penis, dilates the blood vessels, thereby optimizing the hemodynamics.

Can be assigned to the pain in acute phase. Therapeutic effect of the ointment is not.

The Omega-3 fatty acids

Omega-3 was tested on Peyronie's disease (due to anti-inflammatory properties)

In 2009 he published a study, a randomised, double-blind study of omega-3 compared to placebo.

A total of 224 patients with early chronic-stage PD were randomized to a dose of 1.84 g daily supplements of omega-3 compared with placebo at 6 months.

Unfortunately, no significant improvement in plaque volume, penile curvature, pain during erection, erectile function. Currently there is no data confirming the positive effects of omega-3 in the early chronic stages of Peyronie's disease.

Omega-3 is useful for any person. Can omega 3 without a prescription. But there was no treatment effect.

Omega-3

The phosphodiesterase 5-inhibitors (inhibitors PDE-5)

Although inhibitors of PDE-5 is generally regarded as the treatment of erectile dysfunction (ED), the latest studies have shown that the potential use in the treatment of Peyronie's disease, in patients with or without ED. PDE5 inhibitors increase cyclic guanosine monophosphate (cGMP) by inhibiting the degradation of GMP to GMP. The increase in cGMP level synthesis, deposition of collagen is inhibited, and the apoptosis of fibroblasts, myo-fibroblasts.

Since this property of the inhibitors PDE-5 useful conversion scars.

At the moment, only one study, which seemed to improve the scar formation in the penis. But all patients were without significant plaques. The curvature was less than 10%.

At the moment, PDE 5 is not assigned. Maybe later, if there will be new clinical trials, proven therapeutic effect.

L-arginine

L-arginine contributes to the reduction of fibroblasts for apoptosis. The underlying mechanisms of L-arginine is considered as a anti-fibrotic agent.

The researchers measured plaque in the penis of the treated rat in inhibitors of PDE-5, l-arginine. Similar inhibitors of PDE-5, L-arginine showed a significant decrease in the size of plaques, the relationship of collagen to the fibroblast. Later research has shown that the arginine protective effect against the formation of scar tissue, when exposed to the penis of the rats.

In 2012, noted that the trend improvement in the curvature in patients with PD treated with therapy of the penis in combination with vnutricletocnam verapamil, oral L-arginine, oral pentoxifylline (PTX). Although this study has many variables that can contribute to improve curvature, it was one of the few human studies in which L-arginine was to treat PD. Since these results, L-arginine may be a useful treatment option for BP, but additional studies are needed by the people.

L-arginine

L-arginine can be assigned complex conservative therapy.

Peyronie's disease without surgery: local administration of drugs

This method is more effective in correcting curvature of the member than the oral sources. Injections are administered under local anesthesia. The proceedings shall be conducted exclusively by experienced professionals.

The drugs in the tunica albuginea of the penis (directly on the plaque, scar). The procedure should be performed with extreme caution, as there is a big risk to aggravate the pathological process, increase the inflammation, the number of, size of the plaques.

The possibility of treatment of injection depends on the size of the plaque, the location, and general condition of the patient. If the injection is a long process, when the surgical treatment of curvature can be disposed of in one operation. The internal consultation, to determine the best treatment option for each patient.