Peyronie's disease: pharmacological treatments and limitations.

Peyronie's disease (PD) is a disorder of the tunica albuginea from disordered and excessive deposition of collagen resulting in a palpable scar, pain, erect penile deformity and erectile dysfunction that significantly impacts patients both physically and emotionally.

Several treatment options have been described for PD, including shockwave therapy, traction therapy, both oral and intralesional pharmacological options, and surgery. This review seeks to examine the data for different types of non-surgical treatments for PD. We review how various treatment modalities impact several relevant clinical endpoints for Peyronie's disease, including effects on pain, penile curvature, plaque formation, and erectile function. We performed a literature search using PubMed and SCOPUS while referencing AUA, EAU, and CUA guidelines for management of Peyronie's Disease for studies published 1980-2020.

Intralesional collagenase injections have the strongest evidence and are the only FDA approved intralesional treatment for PD. Penile traction therapy (PTT) is low risk and may be beneficial in patients willing to invest significant time using the devices. Furthermore, oral combination therapy with other modalities may provide some benefit. Further investigation is required to better understand pathophysiology of PD and clarify the therapeutic utility of existing treatments, potentially with a multimodal strategy.

Expert review of clinical pharmacology. 2021 Mar 15 [Epub ahead of print]

Eric V Li, Robert Esterquest, Minh N Pham, Evan J Panken, Channa Amarasekera, Aisha Siebert, Petar Bajic, Laurence A Levine

Northwestern University, Feinberg School of Medicine, Department of Urology, Chicago, IL 60611, United States of America., Rush University Medical Center, Division of Urology, Chicago, IL, 60612, United States of America., Cleveland Clinic, Center for Men's Health, Glickman Urological and Kidney Institute, Cleveland, OH, 44195, United States of America.

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