Conservative therapy of Peyronie's disease - update 2015

Abstract

Peyronie's disease (PD) is a benign disease of the penis leading to development of fibrous plaques at the penile tunica albuginea. PD is a heterogeneous disease with variable constellation of symptoms (penile deviation, pain, penile shortening, erectile dysfunction). Due to lack of pathophysiological knowledge there is no causal therapy of PD. Surgical therapy still represents the gold standard for correction of penile deviation. Available conservative treatment options vary from oral medical therapy to minimally invasive treatments (e.g. iontophoresis) and invasive treatment modalities (e.g. intralesional therapy). A gold standard for the conservative therapy of PD does not exist due to the nonhomogeneous disease and the variable constellation of symptoms. New conservative treatment options like penile traction and also promising treatments like intralesional injection therapy with collagenase have to be further investigated and prove their efficacy in the long-term. Moreover, well-structured, standardized, randomized placebo-controlled studies have to be done for each of the treatment modalities, so that patients can be offered successful and evidence-based conservative therapies in the future.