Local therapy for Peyronie’s disease

The natural history of Peyronie’s disease is extremely variable. There are no clear, efficacious medical treatments. Local therapy includes pharmacotherapy and mechanical therapy. Degree of penile curvature is the critical end point for studies, although plaque size, erectile function, and pain are also important. Intralesional treatment with verapamil is the most commonly used therapy and has shown positive results, mostly in nonrandomized, noncontrolled trials. Interferon has shown efficacy in a large, multicenter, placebo-controlled trial but has significant flu-like symptoms. New data with collagenase show promise, and large, multicenter clinical trials are due to begin in 2008. Mechanical therapy with penis extenders has been introduced in the past year in an attempt to straighten and lengthen the penis in patients with Peyronie’s disease. More double-blind, randomized, controlled studies are necessary to better analyze these minimally invasive modalities in the treatment of Peyronie’s disease.