Conservative treatment for peyronie's disease can be in acute phases and in the initial stages. With pills and injections can relieve the pain, stop the inflammation. Get rid of the external signs of the curvature of the member is possible only by injection into the plaque or surgical.
On the first symptoms of penile curvature, it is necessary to consult with specialists. The doctor andrologist will select for you the most suitable solution to the problem. After the diagnosis may be the appointment of conservative therapy.
The fundamental principles and objectives of conservative treatment of peyronie's disease are:
Perhaps the use of physiotherapy, oral medications, topical therapy, injection therapy. For the treatment of peyronie's disease in the early stages, it can only help in the complex therapy, which will include a number of approaches.
There are several drugs that have passed clinical trials and is effective in peyronie's disease. Each of them provides its effect, while focusing on different stages of pathogenesis, which requires their integrated application.
Only when internal examination and Doppler ultrasound of the penis, a doctor can indicate what type of treatment can be effective (much depends on the causes of illness).
This medication has a number of beneficial therapeutic effects:
Suitable for the treatment of adult men with peyronie's disease with a palpable plaque and curvature deformity of at least 30 degrees at the beginning of the treatment. Injected directly into the plaque. Each injection helps to reduce and destroy plaque and help straighten the curvature of penis, called peyronie's disease.
Vitamin E, a fat-soluble antioxidant that inactivates free radicals, which are saturated with nitric oxide (NO), therefore, is to maintain the high level of the active NOT to provide adequate treatment. Limit oxidative stress, which is also a potential anti-inflammatory effect. It was first described in the treatment of peyronie's disease in 1948 and due to its low cost and availability remains the most commonly prescribed oral agent for the treatment of PD. Nevertheless, its use in the last seven decades, more placebo-controlled studies have not shown significant improvement in pain, degree of curvature, plaque size or to restore your erection. In 1983, Pryor and Farrell completed a double-blind, placebo-controlled study of vitamin E in 40 patients with PD and found no significant improvement in plaque size or penile curvature. In addition, a more recent study, conducted in 2007, in the largest study of vitamin E in the treatment of peyronie's disease. The authors compared vitamin E alone and in combination with L-carnitine with placebo in 236 men with the early chronic PD; classified as a patient with pain during erection, penile curvature not affecting vaginal penetration, painless palpabile the scar, the damage hyperechogenic with ultrasound of the penis, the absence of calcification, and total surface area of the plates of <2 cm2.
Group 1 (58 men) received 300 mg vitamin E orally twice a day.
Group 2 (59 men) received propionyl-L-carnitine 1 g orally twice a day.
Group 3 (60 men) received 300 mg vitamin E orally twice a day, and 1 g of propionyl-L-carnitine orally twice a day.
Group 4 received a similar regimen of placebo during the 6-month probationary period. After the treatment there was no significant change in reducing curvature of the penis between the four groups (P = 0,9), and also in reducing the size of the panels (P = 0.1) (12).
Despite the lack of evidence to support the effectiveness of vitamin E, it is still commonly prescribed prescribed along with other drugs with the hope on the synergistic role. Common side effects when using vitamin E are nausea, vomiting, diarrhea and an increased risk for development of prostate cancer.
Heparin ointment reduces inflammation of the tissue in the penis, which dilates the blood vessels, thus to optimize hemodynamics.
Can be assigned for pain in the acute phase. The therapeutic effect of the ointment will not.
Omega 3 has been tested with peyronie's disease (due to anti-inflammatory properties)
In 2009, the commission published a study in the randomized, double-blind study of omega-3 in comparison with the 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 the placebo for 6 months.
Unfortunately, there has been no significant improvement in plaque volume, penile curvature, pain during erection and erectile function. Currently there are no data that confirm the positive effects of omega-3 in the early chronic phases of peyronie's disease.
Omega 3 is helpful for every person. You can take omega 3 without prescription. But there was no treatment effect will be.
Even though inhibitors PDE-5 are generally considered for the treatment of erectile dysfunction (ED), recent studies have shown the possibility of their use in the treatment of peyronie's disease in patients with or without ED. Inhibitors of PDE5 increases cyclic guanosine-monophosphate (cGMP) by inhibiting the degradation of GMP for GMP. By increasing the level of cGMP and NOT the synthesis and deposition of collagen are inhibited, and apoptosis of fibroblasts and myo-fibroblasts.
Due to these properties of the inhibitors of PDE-5, it can be useful for the transformation of the scars.
At the moment, when there was only one study, which seemed to improve the scar formation on the penis. But all of the patients were without major plates. And the curvature was less than 10%.
At the moment, PDE 5 is not assigned. Maybe later, when there will be new clinical trials and has been proven therapeutic effect.
L-arginine contributes to the reduction of fibroblasts for apoptosis. The mechanisms underlying L-arginine is considered as a anti-fibrotic agent.
The researchers measured plaque in the penis in rats treated with inhibitors of PDE-5, and l-arginine. A similar inhibitors of PDE-5, L-arginine showed a significant reduction in the size of boards and the relationship of collagen by fibroblast. More recent research has shown that arginine has a protective effect against the formation of scars when exposed to the penis of rats.
In 2012, he found that the trend of improvement in the curvature in patients with PD treated with therapy of the penis in combination with vnutricletocnam verapamil, oral L-arginine and oral pentoxifylline (PTX). Although this study has many variables that can contribute to improve curvature, it was one of the few human experiments in which L-arginine has been used to treat PD. Based on these results, L-arginine may be a useful treatment option for BP, but further testing is needed on humans.
L-arginine can be assigned complex conservative therapy.
This method is more effective in correcting the curvature of the member than the use of oral sources. Injections are administered under local anesthesia. The procedure should be carried out exclusively by experienced specialists.
Drugs are entered in the tunica albuginea of the penis (directly in the plaque and scar). The procedure should be done very carefully, because there is a big risk to aggravate the pathological process, increase inflammation, the number and size of panels.
Treatment option injections depends on the size of the plaque, its location and the General condition of the patient. If the injection is a time-consuming process, during surgical treatment of curvature can be disposed of in one operation. On internal consultation to determine the best treatment option for each patient.