Minimally invasive treatment of Peyronie's disease: Evidence-based progress - Abstract
Published on 05 February 2014
Peyronie's disease (Peyronies Disease) is often physically and psychologically devastating for patients, and the goal of treatment is to improve symptoms and sexual function without adding treatment-related morbidity.
The potential for treatment-related morbidity following more invasive interventions, such as surgery, creates a need for effective minimally invasive treatments. We critically examined the available literature using levels of evidence to determine the reported support for each treatment. Most available minimally invasive treatments lack critical support for effectiveness due to the absence of randomized, placebo-controlled trials (RCTs) or nonsignificant results after RCTs. Iontophoresis, oral therapies (vitamin E, potassium para-aminobenzoate, tamoxifen, carnitine, and colchicine), extracorporeal shock wave therapy, and intralesional injection with verapamil or nicardipine have shown mixed or negative results. Treatments that have decreased penile curvature deformity in level 1 or level 2 evidence-based, placebo-controlled studies include intralesional injection with interferon α-2b or collagenase clostridium histolyticum.
KEY MESSAGES: Peyronies Disease is now understood to be a chronic disease with the need for symptom management from disease onset throughout the lifetime of the patient. Effective minimally invasive treatment options are highly desired by patients. The minimally invasive treatments with the highest level of evidence supporting effectiveness in improvement of penile curvature deformity include intralesional injections using interferon α-2b or collagenase clostridium histolyticum. Recognition of Peyronies Disease and initiation of an evidence-based minimally invasive treatment are key to improving patient outcomes.
Jordan GH, Carson CC, Lipshultz LI. Are you the author?
Department of Urology, Eastern Virginia Medical School, Norfolk, VA, USA.
Reference: BJU Int. 2014 Jan 21. Epub ahead of print.