Last updated: May 17, 2008
bent-nail-peyronies
Peyronie's essentially ends up being arthritis of the penis.
(VEER/HEALTH)
Some cases of Peyronie's disease will improve without treatment, while others require medication or surgery to correct the curvature resulting from damage to the penis. The idea is to reduce the pain associated with the condition while preserving a man's ability to enjoy sex.


1. Arthritis meds
"Peyronie's disease ends up being arthritis of the penis," says Irwin Goldstein, MD, director of San Diego Sexual Medicine and the editor in chief of the Journal of Sexual Medicine. "So there are a number of therapies for arthritis that can be used for Peyronie's, like anti-inflammatories." Anti-inflammatory treatments include Potaba, which the Food and Drug Administration has labeled "possibly effective" for treating Peyronie's disease, as well as colchicine. However, large doses of Potaba are needed for this treatment, and it may cause stomach upset.

2. Injections
Your doctor may choose to try an injection to help reduce the swelling and pain associated with Peyronie's disease. "Injecting drugs such as collagenase, verapamil—a calcium channel blocker—and interferon-alpha-2b is an option," says Dr. Goldstein, "though only interferon has been shown to be effective."

3. Steroids
One of the best ways to stop pain that is resistant to more conservative treatments (such as ibuprofen), says Dr. Goldstein, is through steroids and steroid nerve blocks. He sometimes recommends injecting a steroid such as Kenalog, along with an anesthetic such as lidocaine, into the penis for quick relief of debilitating pain.


4. Surgery
Not all doctors agree on treatment with medications. Ira Sharlip, MD, spokesman for the American Urological Association and clinical professor of urology at University of California at San Francisco, believes there aren't any effective treatments other than corrective surgery.

Surgery may help, but it is generally reserved for more serious, long-term cases.There are three kinds of surgical treatments for Peyronie's disease.
• Nesbit procedure (or Nesbit plication): Tissues in the area of the penis opposite the affected ones are removed or pinched to correct the bend. The procedure can shorten the length of the erect penis, however, so doctors generally reserve this surgery for men with adequate penis length and cases that don't involve an extreme curvature.

• Plaque incision with saphenous vein graft: For someone with a shorter penis, a more severe curve or an hourglass-shaped penis, a doctor might choose to make incisions in the plaque and graft a vein in the area.

• Prosthetic implant: An implant, such as those used for erectile dysfunction, may also help to straighten out the curve from Peyronie's disease and increase the penis's overall hardness.