Peyronie’s disease: options in pharmacologic management

Abstract

Peyronie’s disease is a connective tissue disorder involving the tunica albuginea of the penis. The fibrotic process may result in the formation of plaque, one of the classic findings on physical examination of the patient. Men afflicted with this disorder may present with pain, deformity, such as penile curvature, and/or erectile dysfunction. While surgical therapy has been the standard for definitive treatment for penile curvature associated with Peyronie’s disease, medical options are attractive due to their potential to avoid invasive procedures of the penis, affect all aspects of disease and intervene before the disease has stabilized and is perhaps still reversible. Oral therapy has been historically popular due to the ease of administration and low side-effect profile but clinical trials have failed to demonstrate clear benefit. Intraplaque injection with agents such as verapamil and interferon, has been demonstrated (in mostly uncontrolled studies) to offer mild-to-moderate benefit and stabilize disease. Studies focused on the topical administration of verapamil have been conflicting, while the use of iontophoresis has gained popularity as a means of improving drug delivery to the target tissues. Further controlled trials are needed to further elucidate effective therapies and their optimum dosing, while further research into the pathophysiology of the disorder will aid in the development of new treatments.