The medical management of Peyronie's disease

There are a wide variety of medical treatments that are available to the practicing urologist, including oral agents, topical creams and gels with or without iontophoresis, intralesional

injection therapy, radiation therapy, extracorporeal shockwave therapy, and laser therapy. Medical management of Peyronie's disease might be a valuable treatment option for this debilitating

disorder, especially in the early symptomatic stages of the disease. Although no single modality has been demonstrated to have superior efficacy, intralesional therapy appears to confer

some benefit. Multicenter, large-scale, randomized, controlled studies are necessary to fully establish the efficacy of the available treatments. Until such trials are conducted, a rational

approach involving combination therapy is the most appropriate method to treat these patients. In this Review, the current medical treatment options available for the management of

Peyronie's disease are discussed and a management algorithm is proposed.

Peyronie's disease is a disorder of the penis occurring in men over 40 years of age, and is clinically associated with penile pain in the flaccid or erect state, penile deviation, penile

plaques, and erectile dysfunction

The aim of medical therapy is to treat and alleviate the morbidity associated with this disease

The etiology is poorly understood, and this might account for the questionable efficacy of some current medical therapies

Several mechanisms have been postulated as the cause in susceptible individuals, including trauma, collagen deposition, aberrant wound healing, and fibrosis

Agents that have been shown in well-designed, randomized, placebo-controlled trials to have an effect in Peyronie's disease include intralesional verapamil, colchicine, and possibly

intralesional interferon

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