Saturday, 19 May 2012

Visitor Email

Dear Peyronies-Disease.co.uk,

I'm 62, have no pain, can become erect but with a 45 degree bend to the left as I look down. I'm 12 months into the bout of peyronies disease. There is the usual hard lump located at the base of the penis which when erect seems to stretch. I don't have intercourse any more because I am too embarrassed to try. I do not want surgery and would welcome your thoughts on Potaba and where do I get it, thanks,

Jack

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Hi Jack,

There are mechanical methods designed to reduce curvature:

Traction: http://www.peyroniesdisease.org.uk/p/traction-penis-extenders.html

VED: http://www.peyronies-disease.co.uk/2009/08/vacuum-erection-device.html 

These types of treatments are designed to stretch the scar tissue and reduce curvature. There are various studies confirming this. They are sometimes used alongside pentoxifylline (which is now typically seen as the drug of choice, over potaba - though I appreciate that can be effective for some men). It's debatable how effective oral treatments are once the condition is stable, compared to when it's active but it can't hurt to try to hit this problem from multiple angles. Where you are seeking advice from a medical professional, it definitely makes sense to find someone with a good knowledge of this specific condition. Not every urologist is a peyronie's disease expert.

Thanks,

Peyronies-Disease.co.uk

Wednesday, 2 May 2012

Treatment Question

Dear Peyronies-Disease.co.uk,

I hope i am not going to bore you with my story I will try to keep it as concise as possible. About two years ago when I noticed a lot of pain when getting erections I went to my GP who referred me to a urologist who examined me and then referred me to a dermatologist [as i had this white discolouration on the glands of the penis] this turned out to be lichen sclerosis. when I went back to the same GP for the sebacyn cyst on the base of my penis he gave me no treatment as he said it would clear itself. After treatment for the lichen I suddenly noticed the lumps in my penis shaft. Another trip to the GP was met with the remark that “you have a nasty disease and nothing can be done” so I contacted my dermatologist to get a referral back to the urologist. There appear to be two plaques, the larger on the right side and a smaller one on the left side both being just below the glans. This has had the effect of looking like someone has taken a bite out of the right side and is causing the glans to bend over to the right hand side. I have been taking vitamin e,c and d for six months but would like to know if ved and traction would also be advisable? With traction devices is it safe to use given the location just under the glans? Would really appreciate your help and advice as I am very reluctant to have surgery if it can be avoided. I am UK based in the midlands.

Thanks,

Michael
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Dear Michael,

Many/most men with peyronie's disease do feel pain for weeks or months leading up to plaque development, and it may have been that the lichen sclerosis diverted you all away from what is likely a more pressing problem. "There's nothing that can be done" isn't great advice to receive from a medical professional, in actual facy it isn't actually advice at all. The "taken a bite out of" aspect is sometimes known as narrowing, and the bend, curvature. While traction is certainly suitable for most men, the positioning of the plaque (just below the glans) does make me think that it might be difficult to achieve anything approaching a stretch, due to the position that traction devices grip the penis. It may therefore be that a VED would be of more use here. There is a positive study relating to usage of vacuum therapy, and in additional to this, plenty of first hand experiences online.

For someone who has been told that nothing can be done you have at least been very proactive. If I had to recommend an oral treatment regimen to go along with the mechanical therapy I would go for pentoxifylline and COQ10 as there are positive peyronie's disease studies for both of them. The former of the two is a prescription drug. It's hard to know what improvement to expect, but it's certainly not uncommon or unwise to try to more conservative approach before considering options like surgery. Also, just to point out, surgery is usually only considered where the condition has been stable for a year or so.

Best,

Peyronies-Disease.co.uk