Dr. Harold Reed Blog

Category Archives: Peyronie’s plication

Peyronie’s (FAQ) | Treatment | The Reed Centre for Ambulatory Urological Surgery

Dr. Reed, Any specific recommendations for treating Peyronie’s?  Have 60 degree ventral (downward) angulation which makes penetration near impossible.. Neil

Der 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

Cordially,

Harold M. Reed, M.D.
The Reed Centre for Ambulatory Urological Surgery – Miami
1-305-865-2000

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)

Xiaflex for Peyronie’s Disease redux

Xiaflex (collagenase clostridium histolyticum of CCH) has been out since about 2010, 1st for Dupuytren’s contracture (palmar) contracture of the hand.  The FDA approved Xiaflex for the treatment of Peyronie’s disease in December 2013.  My opinion as to the practical value considering the results and cost has not been laudable to say the least.  But…Continue Reading

Peyronie’s with lateral curvature

Dear Dr. Reed,  What approach would you recommend for Peyronie’s with lateral curvature.  Have had the condition for about 3 years, and has not worsened after the initial sexual trauma.  Can feel some plaque on the right, and curves to the right.  Able to have sex in  limited positions with occasional discomfort as noted by…Continue Reading

Peyronie’s with lateral curvature and some degree of erectile dysfunction ED

    Dear Dr. Reed, I developed Peyronie’s after female above trauma.  Had some degree of erectile dysfunction ED before that, but now ED is worse.  Viagra helps somewhat but still intromission is difficult.  Randy Dear Randy, My recommendation is to have a simultaneous insertion of a Penile Implant and correction of Peyronie’s.  Chances are…Continue Reading