Peyronie’s disease is caused by progressive fibrosis (plaque) of the normally elastic tunica albuginea (the lining of the erectile tubes within the penis) resulting in curvature or other deformities of the erect penis. There may be pain initially, or it may be the curvature or scar tissue that is first noticed. There is a genetic predisposition. The incidence of PD has been found to be as high as 9%.
PD is thought to be an overresponse to minor trauma of the penis which usually goes unnoticed. If the curvature is excessive, vaginal penetration can be difficult, partners may suffer pain resulting in significant emotional distress to both.
For diagnosis, normally a history and examination is sufficient but at times a penile ultrasound or penile Doppler ultrasound may be indicated.
Perth Men's Health Conservative Treatment Protocol consists of all or a mixture of the following:
- Cialis 5mg: Reduces inflammatory changes associated with oxidative stress and reversing the fibrotic process in the Peyronie's plaque. Cialis will also improve erectile function.
- Penile Traction Therapy: Shown to produce remodelling of the fibrotic (collagen) tissue to reduce penile curvature and improve erectile function. The Perth Men's Health protocol uses a Vacuum Erection Device (VED).
- Low Intensity Shockwave Therapy (LISWT): Electron microscopy demonstrates a reduction in packing and clumping of the collagen fibres with a reduction in the hardness of the plaque. This can result in reduced curvature, reduced pain and improvement in erectile function. These 3 treatments therefore complement each other with the goal of additional benefits.
- In the first 6 months of onset, a combination of high dose anti-inflammatory and antioxidants (L-Arginine, L-Carnitine & Curcumin) will impede further scar formation.
- Colchicine is used for pain relief if required.