One important aspect of treating Peyronie’s Disease is differentiating those in the early (or ‘acute’) phase of disease compared to those who in a more stable (or ‘chronic’) state. Although the time since onset is often one way that we separate acute vs chronic, in reality, there is no perfect method. Men who experience ongoing pain or changes in curvature/deformity are likely in an ‘acute’ phase. The reason this is important is because the treatments are generally different depending on which phase you are in.
In general, men in the early phase have things that they should do (i.e. traction), could do (i.e. Xiaflex or interferon), and should not do (i.e. surgery). The main reason traction is recommended in this setting is based on a few studies. One of these compared men who did or did not use traction beginning within the first 3 months of symptom onset, and it showed that the traction group experienced decreases in curvature (on average) from 33 to 15 degrees. In contrast, the non-traction group experienced a worsening of curvature from 29 to 51 degrees. As far as Xiaflex or interferon, available studies have shown that they have similar outcomes when used in any time frame of treatment, not necessarily in just the acute phase. There are also dozens of other treatments which have been described, such as pentoxifylline, vitamin E, colchicine, L-carnitine, Potaba, PDE5s, verapamil, shock wave, platelet-rich plasma, stem cells, etc., etc. However, most of these other therapies either have no data or conflicting data on their efficacy, and therefore, more study is required before they can be routinely recommended.
It is very important to begin treatment for the symptoms of PD as soon as possible. It is much easier to prevent severe deformity than it is to treat it once it has fully set in. In contrast, once PD has fully stabilized, there is no ‘rush’ to treat, and treatment may be performed immediately or in a delayed manner.
But what happens if men in the early phase of PD choose to just observe? One good study which examined this question showed that 48% patients who did no treatments at onset found that symptoms worsened, while only 12% found that symptoms improved. In addition, the improvement was only by 12 degrees of curvature, while the worsening was at a 22 degree curvature.
You can learn more about symptoms, treatments and studies on Peyronie’s Disease on our website.
