Acquired penile curvature course and treatment

Course in two phases

Typically, the disease progresses in two phases. In the first active phase developed an increasing curvature of the penis and an erection is painful. This phase is about 6 to 12 months in a stable phase of the disease, in which no further progression of the curvature is recorded and the pain subsides. In the early stages are usually not have any power problems. These can be adjusted with the disease progresses.

Spontaneous regression of


The progression is unpredictable. In about 13 percent of cases, especially at the beginning of an independent regression of the disease without treatment.


Therapy is difficult
The overall treatment design difficult. It can not eliminate the causes of the disease, but only the symptoms can be improved. The treatments include both medications and surgical techniques, extracorporeal shock wave therapy, radiotherapy and various.


Drugs

Drug therapy:

    Para-aminobenzoic acid: One study found that para-aminobenzoic acid causes about 6 months after taking a fall of hardening. The progression of penile curvature is stopped. An existing distortion remains.
    Acetyl-L-Carnitine: The ingestion causes a significant reduction in pain and possibly an improvement in the curvature.
    Vitamin E and colchicine studies showed no clear effect.

Drugs can be injected directly into the induration (intralesional therapy). The therapeutic results of Verapamil injections, collagenase and cortisone injections are not clear and controversial.


Ultrasound and radiotherapy
Extracorporeal shock wave therapy (ESWT): It is assumed that the ESWT causes a destruction of the calcifications and also improves blood circulation. This method can indeed be achieved faster pain relief, but not a drop of curvature or a reduction of the plaques. The same is true for radiation therapy. For this reason, the two methods are not generally used for the treatment of acquired penile curvature.


Surgical therapy

An operation is considered,

    when all other treatments were unsuccessful,
    if the person complains of severe pain and
    a significant curvature exists.

A surgical procedure should only be in the stable phase of the disease made, such as after a period of at least 12 months. The surgical procedure is performed too early, there is the risk of recurrent deformity by reactivation of the inflammatory process.


Surgical methods


Various surgical methods are used:

    With low distortion and preserved erectile function called Nesbit method is suitable.
    With strong capacity for erection and curvature usually surgical removal of plaque and subsequent replacement of the missing tissue either by the body's own tissue (veins, skin) or collagen fleece is made.
    In the absence of erectile function can be considered a penile prosthesis.


Risks of surgery


For all surgical procedures there is a risk that caused shortening of the penis, reducing the perception of touch (sensitivity) and impotence (erectile dysfunction). Therefore, the indications for surgery are too close together. Only with considerable problems during intercourse, it seems appropriate to justify the risks of surgery.