Sunday, 24 October 2010

Treatments

Below is an overview of a typical approach to treating peyronie's disease.

Oral Treatments - Front Line Treatments

Pentoxifylline - A prescription medication. Pentoxifylline has been offered to peyronie's patients since 2002 by renowned peyronie's disease expert Dr Tom Lue (and others). It's a conservative treatment and only moderately effective, but studies exist to back it up.

Second Line Treatments

These treatments either have positive studies directly relating to peyronie's disease treatment (COQ10, ALC) or in theory may be useful in combination with front line treatments.

Coenzyme Q10 - A very recent study suggesting that Coenzyme Q10 may have a meaningful place in peyronie's disease oral therapy. Time will tell whether or not this is the case.

Acetyl L Carnitine - The linked text directs you to a positive acetyl-l-carnitine study from a few years back. Acetyl L Carnitine isn't exactly heavily researched for the treatment of peyronie's disease, but it can't hurt to try it.

PDE5 inhibitors inhibitors (Viagra, Cialis, Levitra --> Comparsion) and L-arginine - Pentoxifylline, L-Arginine and Viagra is sometimes known as the PAV cocktail. It has been prescribed by some of the top urologists in the states as a combination aiming to help combat peyronie's disease.

Other Treatments

These treatments I'd describe as 'general', in the sense that they have not been shown to help with peyronie's disease (often no studies have involved their use), but in theory they have help reduce inflammation, scarring and so on in other conditions. Hence, they may be of use.

Pycnogenol - When combined with L-arginine pycnogenol is known to promote and improve the quality of erections. It it sometimes known as Prelox. Multiple studies support its effectiveness in treating mild to moderate erectile dysfunction.

All of the following also have anti inflammatory and/or antifibrotic qualities: Taurine, Vitamin D, Curcumin, Resveratrol.

Note: It is recommended that oral treatment regimens are combined with a mechanical treatments such as Traction or Vacuum Therapy. Typically traction or vacuum therapy is tried for 6 months or so. If the improvement is not satisfactory to the patient, he may consider that it is worthwhile sticking with these treatments, or undergoing surgery. Surgery only takes place when the condition is stable (typically a year or so after onset). Not all cases of peyronie's disease follow typical timescales. A urologist will advise you on which path to take. Helpful communities such as the peyronie's forum, may also provide comfort and assistance to sufferers.

Wednesday, 20 October 2010

Bent Penis

If you've found your way here, possibly by searching for the term bent penis, it's likely that you have concerns about the shape of your penis and wish to see what treatment options are available. In short, if you have a bent penis the condition is either caused by congenital curvature or peyronie's disease.

With congenital curvature the penis has always been curved and has not changed in shape in recent months or years. Congenital literally means 'existing at birth'. Often the curvature is slight and of no consequence, but sometimes it is more pronounced creating a feeling of insecurity and in more severe cases making sexual intercourse difficult.

Peyronie's disease, an inflammatory condition, differs in that it develops over time and as such it can be very noticable and psychologically troubling. Sometimes peyronie's disease is caused by a sexual injury, but often there is no noticable event. PD can be painful, but isn't always, and curvature and nodules can develop suddenly or over a period of time. The curvature is caused by plaque (scarring) which reduces elasticity within the penis. It can also be widespread rather than localised resulting in a shortening of the penis rather than noticable 'bent penis' appearance.

For peyronie's disease studies indiciate that pentoxifylline is a somewat useful oral treatments. There are also various studies demonstrating that traction devices can be used to significantly reduce curvature. As can ved therapy. There are surgical options too, though it certainly makes sense to try conservative options first.

For congenital curvature I would suggest traction as way of stretching the short side of the penis. Traction devices have been shown to be able to stretch tissue within the penis, increasing length in the process. Where there is curvature, the curve exists due to that part of the penis being shorter. As such this is the tissue that would be stretched by such a device [Product Page].

More traction device info:

Thursday, 14 October 2010

Vitamin D

I've blogged about many supplements on this blog before, so it seems like to good idea to make sure that Vitamin D is covered too. I don't wish to portray Vitamin D as a peyronie's disease specific treatment, because it isn't, but in terms of general health it deserves to be highlighted. Peyronie's disease often brings about an increased awareness and responsibility for ones general health and this is an extension of that.

Over the past few years, the momentun behind vitamin D, better described as a hormone rather than a vitamin, has been growing steadily. A great many of us are deficient in the vitamin, with diets lacking in sufficient Vitamin D, and exposure to sunlight lacking in the colder months. In some countries common foods are often fortified, but I've noticed that Vitamin D fortification isn't anywhere near as common here. Vitamin D levels in individuals can vary significantly. 5000 Units per day isn't a particulalry outlandish amount to take and aiming for a 25-hydroxy vitamin level of 60-70 ng/ml is thought to be about right (recommended by the popular heartscan blog).

Vitamin D is known to influence over 200 genes associated with common disease and ailments and those with adequate levels of it have significantly reduced incidences of several cancers. A deficiency of vitamin D can promote inflammation, which is certainly a concern for those of us with peyronie's disease.

Vitamin D tests are more common nowadays as deficiency in the vitamin is become recognised in many quearters. Take a look at this recent news item from the BBC News website concerning low vitamin D levels throughout Scotland, and this article about deficiencies amongst certain racial groups. The idea that Vitamin D only relates to bone health is very outdated and unhelpful.

Wednesday, 13 October 2010

Coenzyme Q10

In August, I posted about a positive Coenzyme Q10 study relating to peyronie's disease. As with all things peyronie's disease related, figuring out the benefits of a treatment tends to be something that takes months rather than days or weeks. As such I can't personally give a recommendation of whether it's a worth treatment, other than suggesting that in trying it, you don't have much to lose, and there is at least potential for gain.

I ordered Healthy Origins COQ10 Kaneka Gels from US company iherb. I tend to order from there because they're professional and offer good value (even after the rather unfair UK customs charges are taken into account).

I'm taking one 300mg pill a day and will continue to do so for six months, at which time I will consider whether or not it's been useful. Bare in mind that I've had peyronie's disease for quite some time, so even if this is useful, I personally may not experience the positive effects of it. If anything, the supplement side of my regimen is to make sure that there's minimal chance of negative changes, while I engage in other treatments (traction, vacuum therapy etc).

A word to the wise. There two available forms of CoQ10, Ubiquinone and Ubiquinol. Your body has to break down Ubiquinone into Ubiquinol in order to use it. When you're young this is easy, but as you get older (40-50+) it becomes more difficult. As such for young people thinking of adopting a CoQ10 peyronie's disease strategy, should probably use Ubiquinone (it's cheaper too) and for those aged 40+ buy a Ubiquinol form of CoQ10.

CoQ10 Study PDF here.

VacADS

There's not exactly a miriad of options on the mechanical side of peyronie's disease treatments (vacuum pumps, traction devices) so aside from covering the basics and protocols used (ved protocol) the conversation usually ends there.

There are variations on a theme though, and the VacADS system is one that I recently tried and which was a positive enough experience to get me to write about it here. The device doesn't use the traditional noose method of fastsize and co. Instead a plastic helmet is placed on the head of the penis, and the device holds in place due to vacuum. It's more comfortable than you'd think and I tend to wear it for around 2 hours then remove it. I only place a light weight on the device, as I feel that I always need to adopt a long term strategy and accept that this isn't the case of waking up tomorrow and everything being back to normal. Also, fear of injury plays a part in such decisions.

The ADS part of VacADS stands for all day stretch. I'm not sure how someone could stretch all day long using this device though, as I imagine that they would experience a degree of fluid buildup due to the prolonged vacuum.

I still use a vacuum pump. I had a period of time where I developed some blood spots, which was frustrating for me, as I wasn't pumping any harder than usual. The supplements and medications that I take do thin my blood slightly though. Everything is a delicate balance and it's important to try to listen to your body and take a steady and sure approach to peyronie's disease treatments. I have considered alternating between traction and vacuum therapy of alternate days. This isn't a protocol that I've seen put forward and I'm not sure how wise it is to move onto the road less travelled. I do feel that there is evidence both strategies have merits though, which is the logic behind my thinking.

Each device has it's drawbacks and it's down to the individual to find out what works best for them. It certainly makes sense to go down the physical/mechanical option route though, as a combined approach of that and oral treatments is beneficial both physically and psychologically in my view. If you have any experiences to share of using either traction of VED (vacuum erectile device) therapy, feel free to post a comment.