Dr. Reed, Any specific recommendations for treating Peyronie’s? Have 60 degree ventral (downward) angulation which makes penetration near impossible.. Neil
You have my sympathies. Every year or so the American Urological Association (AUA) update the guidelines for treating Peyronie’s There are 2 stages.
The first is the active phase which include pain and worsening of deformity. Surely surgery is not indicated until there has been stability for 6 months to a year. Vitamin E thought to be helpful in reducing scarification has been delisted. Injection with Interferon has a “moderate” approval and Xiaflex (collagenase clostridium histolyticum) is exceedingly costly and papers from centers where this is used show on average… some improvement but seldom a cure. Also of help may be penile traction. Injections with Verapamil vs. normal saline (salt water) in one study shows them to be equally effective lending credence o the concept that perhaps just the needle sticks are breaking up the plaque. On rare occasions angulation may improve just with tincture of time.
Before considering surgery a color coded duplex Doppler ultrasound (CCDDUS) should be performed to assess the vascularity of the penis. If your erections are beginning to become impaired, then perhaps simultaneous insertion of an implant and molding or corrective plaque surgery can be performed simultaneously.
Please see before and after photos of Peyronie’s surgery on http://penisdoctor.com/before-after-peyronies
Harold M. Reed, M.D.
The Reed Centre for Ambulatory Urological Surgery – Miami
Pre-op before photo of Peyronie’s
After surgery photo of Peyronie’s (patient of Dr. Reed)
After surgery photo of Peyronie’s (same patient of Dr. Reed)