Conservative management options for Peyronie's disease.

Area of Science:

• Urology
• Andrology
• Men's Health

Background:

• Peyronie's disease is an acquired penile condition causing induration, plaque, or curvature, often with painful erections and associated erectile dysfunction (ED).
• Increased ED treatment with phosphodiesterase inhibitors may be linked to more Peyronie's disease presentations.
• Recent years have brought advances in understanding Peyronie's pathophysiology, leading to various nonsurgical treatment proposals.

Purpose of the Study:

• To review the natural history of Peyronie's disease.
• To discuss the scientific understanding of the disease's pathophysiology.
• To outline nonsurgical treatment options for mild to moderate Peyronie's deformities.

Main Methods:

• Review of existing literature on Peyronie's disease.
• Analysis of the natural history, including spontaneous resolution and improvement.
• Evaluation of systemic, local, and intralesional nonsurgical therapies.

Main Results:

• Few randomized, placebo-controlled trials exist for many proposed nonsurgical therapies.
• The natural course of Peyronie's disease can involve spontaneous resolution of pain and some improvement in curvature.
• Nonsurgical treatments are available for mild to moderate cases, while surgery is primary for severe or refractory conditions.

Conclusions:

• Understanding Peyronie's disease pathophysiology has spurred nonsurgical treatment development.
• Nonsurgical options are reviewed for mild to moderate cases, acknowledging limited high-quality trial data.
• Severe Peyronie's disease with functional impairment typically requires surgical intervention.