Treatments for Peyronie’s Disease include injections such as collagenase and interferon alfa-2b, medications for erectile dysfunction, and, in more advanced cases, surgery.
Peyronie’s Disease is an acquired condition that affects the tunica albuginea and leads to penile curvature during erection. Although the condition worries many men, treatments are available — and, in some cases, curvature correction can be done through clinical approaches, without the need for surgery.
A guideline prepared by the Brazilian Society of Urology, published in the Revista da Associação Médica Brasileira, brings together the main scientific evidence on the efficacy and safety of clinical treatments. In total, 37 highly relevant studies were selected to support the SBU recommendations.
In addition to guiding paths for treatment, the existence of this guideline gives patients more confidence to seek professional help and avoid false promises for penile curvature.
Continue reading and find out which evidence-based approach can be personalized for your case.
What are the causes of Peyronie’s Disease?
Peyronie’s Disease is a condition characterized by the formation of fibrotic scar tissue in the tunica albuginea of the penis, with multifactorial origin.
One of the main causes is associated with repeated trauma or microtrauma to the penis during sexual activity, which triggers an inflammatory process and contributes to the development of fibrosis.
The causes also include the following triggering factors:
- Genetics
- Previous pelvic or penile surgeries
- Previous erectile dysfunction
The prevalence of Peyronie’s Disease can range from 0.4% to 13%, according to an analysis published in the World Journal of Men’s Health.
The risk increases with age: a review from StatPearls points out that the incidence tends to rise with aging, being more common in men between 40 and 70 years.
Men with erectile dysfunction or diabetes have an even higher likelihood of developing the condition.
Symptoms of Peyronie’s Disease
The most common symptoms of Peyronie’s Disease can compromise sexual function, affecting erection rigidity and making performance difficult at the crucial moment. The following signs are usually noticed with the penis erect:
- Abnormal penile curvature;
- Penile pain;
- Penile retraction (shortening of the penis);
- Areas of narrowing along the penis;
- Impact on sexual function (difficulty or inability to maintain rigid erections).
In addition to physical changes, the disease can cause emotional and psychological impacts, such as insecurity, anxiety, and decreased self-esteem.
Evidence-based treatments for Peyronie’s Disease
Men who face problems resulting from penile curvature should turn to scientific evidence to guide treatment, avoiding unreliable information.
In this context, the consolidated recommendations of the Brazilian Society of Urology (SBU) for clinical treatments include:
Collagenase (CCH)
Collagenase is an enzyme applied directly to the fibrotic plaque of the penis, with good results in reducing curvature in cases of Peyronie’s Disease with angles between 30° and 90°.
Studies indicate that, on average, there was an approximate 17° reduction in curvature, with reports of improved satisfaction in some patients — especially when associated with penile modeling sessions.
The most common side effects include bruising, pain, and swelling. More serious complications, such as injuries to the corpora cavernosa, are rare but possible. Collagenase has also demonstrated safety and efficacy during the acute phase of the disease.
However, its use has not been evaluated for calcified plaques or hourglass deformities.
Interferon alfa-2b (INF α2b)
Interferon alfa-2b is another substance used in penile injections applied directly into the plaque. It has shown moderate efficacy in reducing penile curvature and plaque size, in addition to providing pain relief.
Results were observed even in plaques located on the underside of the penis, regardless of disease duration.
Reported side effects are generally mild and include local pain, swelling, bruising, fever, and body aches.
Hyaluronic acid
Hyaluronic acid injection showed greater effectiveness than verapamil gel in the initial phase of Peyronie’s Disease. Research indicated an average reduction of 4 to 5 degrees in curvature, with reports of improved erectile function and satisfaction in some cases.
No adverse events were recorded in the study, which makes hyaluronic acid a safe and promising option — especially for those in the early stages of the condition.
H-100 gel
H-100 gel is composed of nicardipine, superoxide dismutase, and emu oil — substances with action on improving circulation and controlling inflammation. This topical therapy should be applied directly to the skin of the penis twice a day.
In a study with patients in the acute phase of Peyronie’s Disease (up to 12 months of symptoms), in certain studies, penile lengthening was observed, reported curvature reduction of up to 40% and pain relief in some patients.
The only reported side effect was mild skin irritation. As it is easy to apply and well tolerated, H-100 emerges as a promising clinical treatment option for recent cases of the disease.
Tadalafil
Alone, the guideline does not recommend the use of tadalafil for the treatment of penile curvature. Its main role is to assist in cases of associated erectile dysfunction, improving erectile function.
However, recent studies indicate that daily administration of tadalafil (5 mg) in the initial phase of the disease may reduce the progression of penile curvature, in addition to providing significant improvement in erectile function.
In addition, the combination of tadalafil with intralesional verapamil, shock waves, or vacuum erection device may offer pain relief, curvature reduction, and improvement in erectile function, without serious adverse effects, as studies demonstrate.
Read more: Does ozone therapy work for penile curvature?
Treatments for Peyronie’s Disease with little or no relevant effects
Intralesional verapamil
Verapamil showed inconsistent results. Although some studies pointed to improvement in plaque size and erection quality, most did not show significant curvature reduction. Therefore, its use is considered to have limited efficacy, and benefits are unpredictable.
Shock waves
Shock wave therapy may relieve pain in some patients, but studies have not shown significant improvement in penile curvature or sexual function when used alone. In addition, there was no relevant reduction in plaque size.
Oral vitamin E
Alone or combined with other treatments, vitamin E did not show significant improvement in curvature, pain, or sexual function, despite being widely prescribed. Prolonged use at high doses may increase the risk of vascular events.
Oral colchicine
Known for its anti-inflammatory action, colchicine did not show relevant effect in reducing pain, curvature, or plaque size in the initial phase of the disease. Factors such as smoking may further reduce its effectiveness.
Carnitine, tamoxifen, and POTABA
These three medications were evaluated in different studies, showing little or no efficacy in improving penile curvature, plaque size, or pain. As they do not bring significant clinical benefits, this recommendation has been abandoned in the treatment of Peyronie’s Disease.
Radiotherapy
Although it has been investigated as a therapeutic option for Peyronie’s Disease, radiotherapy did not show advantages. Considering the potential risks of radiation exposure, the guideline advises against its use in cases of the disease.
Home treatment is not an option to cure Peyronie’s
Many men still resort to home methods to avoid appointments, tests, or surgeries, without considering the risks involved. These treatments are not only ineffective, but can worsen the condition.
Mistaken practices, such as using teas, exercises or devices that promise to straighten the penis, have no scientific support and can cause permanent injuries — especially when there is no medical indication.
Surgery for Peyronie’s is another treatment recommended to reverse the disease
When clinical alternatives do not present satisfactory results — generally in the chronic phase of the condition — surgery for Peyronie’s is recommended so that the man recovers the characteristics of the penis and rigidity as much as possible.
The most used procedure is the Egydio Technique, performed on the short side of the penis, which is expanded with the help of small incisions. This intervention not only aligns the penis, but also allows the recovery of length and girth, respecting the limits of the nerves, in addition to preparing the organ for the placement of a penile prosthesis, if necessary.
Read more: Complementary therapies for Peyronie’s Disease
Dr. Paulo Egydio can help you find the best treatment for Peyronie’s Disease
Peyronie’s Disease requires personalized, safe, and evidence-based treatment. Therefore, it is essential to rely on the experience of Dr. Paulo Egydio as soon as possible.
A urologist and andrologist, Dr. Egydio is a reference in the treatment of penile curvature, with dedication that began during his doctoral studies at the Hospital das Clínicas of USP, 25 years ago.
He regularly participates in international congresses to ensure treatments that promote quality of life for the patient, always with respect for the man.
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He will assess the phase of the disease, the type of curvature, the presence of pain, erectile dysfunction, and other associated conditions, ensuring that you have access to the ideal treatment.
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