Peyronie’s Disease Treatments
Peyronie’s disease (named after François de la Peyronie, surgeon to King Louis XV of France) is the hardening of tissue (fibrosis) in the penis. A lump or plaque (scar tissue) forms on the lining of the erectile tissue which holds much of the blood in the penis during erection. In most cases, a hard lump can be felt at the point where the penis curves. The hardened area or plaque prevents normal stretching and can affect the size and shape of the erect penis. In severe cases, the plaque can include the muscle and arteries of the penis leading to erectile problems.
What are the symptoms?Peyronie’s disease (PD) begins as a small swelling or inflammation which hardens into a lump on the upper or lower side of the penis. It usually develops over time but sometimes appears very quickly. Some men notice PD after an injury to the penis. These men often describe hearing a loud ‘crack’, with pain and bruising of the penis. However, in many cases men cannot remember any injury happening. |
 |
New Treatment For Peyronie’s
PD can be painful, reduce flexibility, and in some cases shorten or create a bend in the penis when erect. Some men find it difficult to get or keep an erection or the penis only becomes hard up to the area of the scar and stays flaccid (not erect) past that point.
How common is Peyronie’s disease?
It is not known exactly how many men have PD as often men do not recognise the problem, are too embarrassed to see a doctor, or do not seek help as the symptoms are mild. One study of men who were seeing a doctor for another reason, reported PD in about 1 in 11 men.
What causes Peyronie’s disease?
The causes of PD are not clear, but it is thought to happen after repeated bending or bumping of an erect penis. The tearing in the lining of the erectile tissue leads to an inflammatory plaque that does not heal normally. Small blood vessels can rupture or burst and interfere with blood flow. Usually this type of injury only swells, or becomes inflamed (red and/or hot), and will heal within a year. However in some men recovery takes longer and scarring can happen. A pre-existing problem with the immune system could explain why some men develop PD after a simple injury to the penis while others recover from the injury. PD usually affects men aged between 45 and 60 years.
How serious is Peyronie’s disease?
PD lumps are benign (non-cancerous), but erections and normal sexual activity can be more difficult. PD can therefore have a major effect on emotional, physical and overall health.
How does Peyronie’s disease affect sexual intercourse?
In mild cases of Peyronie’s, where the lump does not cause the penis to bend very much, or at all, the effect on intercourse is usually small. However, moderate or severe PD can make intercourse impossible due to the shape of the penis or problems with getting an erection.
How is Peyronie’s disease diagnosed?
A general practitioner (GP) can usually diagnose PD based on a physical examination. Lumps can often be seen and felt when the penis is flaccid (not erect). However, the penis needs to be erect for the doctor to see how much it is bending. To avoid having an erection in the doctor’s surgery, the man may be able to take a photo of his erect penis at home. Medicine to help get an erection is sometimes given by the doctor.
Why is ultrasound or X-ray sometimes used?
An ultrasound (penile colour duplex ultrasound) is used to show the exact location, size and shape of the Peyronie’s plaque (hardened area) and to check the blood flow in the penis. It will also show any calcification (calcium deposits), that happens in about one in three men with PD. Calcification usually means the PD has run its full course and the lump is not likely to get worse (end stage disease). This is useful to know when planning treatment.
How is it treated?
Some men do not need treatment for PD because it does not become serious enough or it gets better over time. Conservative (non-surgical) treatment of PD is usually not very successful and or long-lasting. The most common form of surgery is plication of the penis. Other types of surgery include
1. Incision of the scar and grafting
2. Implanting a penile prosthesis
How are surgical treatments selected?
If the curvature or pain continues for more than 12 months, especially if there are problems with having sexual intercourse. The choice of the type of surgery is based on the following:
1. the man’s ability to get and keep an erection
2. the length of the penis
3.how much the penis is bent or curved
What is plication?
Penile, or corporeal, plication involves making a tuck using stitches in the lining of the penis. This is done on the side opposite the bend to straighten the penis. Known as the Nesbit procedure, it is a simple operation with few side-effects, other than making the penis shorter. It is best suited to men with good erectile function, only a slight bend, no pain, and where a shorter penis will not be a major problem.
What is incision of the scar and grafting?
Incision of the scar and grafting involves cutting the scar tissue to release the penis so that it returns to its original length. The opened area is then patched (grafted). This type of surgery can successfully treat pain, curves and other problems caused by PD. However, it is technically more difficult than plication and has a higher risk of side-effects. The risk depends on the size and location of the plaque. To do the surgery, the nerves in the penis are disturbed, leading to numbness in the penis in up to 10 per cent of men. The main side-effect is erectile dysfunction and the chance is greater if the man has a history of erectile problems. Plication is often offered first, as it is a simpler treatment. Incision and grafting is offered to men with serious scarring and where a short penis is a major problem for them.
When are penile implants used?
Men with PD and erectile dysfunction can be helped by a penile implant. Sometimes an implant alone will straighten the penis. However, often the plaque will need to be removed and grafted before the implant is put in, to completely fix the problem.
What non-surgical treatments are available?
Non-surgical treatments for PD include oral medicines, steroid injections, wave treatments and penile traction (extender) devices. But success has been limited, and there may be complications. There is some debate about using steroid injections, especially cortisone, but these are not recommended as they can damage healthy tissue in the penis.
Xiaflex® (collagenase clostridium histolyticum) is a treatment now available in New Zealand. Collagenase clostridium histolyticum is an enzyme produced by the bacterium Clostridium histolyticum that dismantles collagen. The signs and symptoms of Peyronie’s disease are caused by a collagen plaque. Injection of Xiaflex® into a Peyronie’s plaque, which is comprised mostly of collagen, may result in enzymatic disruption of the plaque. Following this disruption of the plaque, penile curvature deformity and patient bother caused by Peyronie’s disease are reduced . Xiaflex® is supplied as a sterile lyophilised powder intended for reconstitution with the provided diluent. It is indicated in the treatment of adult men with Peyronie’s disease with a palpable plaque and curvature deformity of at least 30 degrees at the start of therapy. Xiaflex® treatment has been shown to markedly reduce penile angulation with improved patient satisfaction and outcome. However due to the significant adverse effect of possible corporal rupture, Dr Morunga believes that Xiaflex® should be administered by a physician appropriately trained in the correct administration of the product, that being a urologist. Mandatory for Xiaflex®
The Priapus Shot®. (Also known as the PShot®) uses Platelet-Rich Plasma (PRP) activated as a Platelet Rich Fibrin Matrix (PRFM) to stimulate the patients own platelet growth factors to generate new connective and neurovascular tissue with applications in Peyronie’s Disease. Learn More About The P-Shot®. Review P-Shot® Data Information.
Are all lumps in the penis Peyronie’s disease?
Not all lumps in the penis are PD. Small bumps, cysts and pimples on the outside of the penis and scrotum are also quite common and generally harmless. Any persistent or painful cyst with a discharge should be checked by a doctor to rule out sexually transmitted infection.
Could it be penile cancer?
The symptoms for penile cancer are very different from the symptoms of PD. Penile cancer generally starts with a tender spot or wart-like bump on the outside of the penis. Bleeding and unusual discharge from the penis are also symptoms of penile cancer. Penile cancer is extremely rare in western countries, although more common in Africa and Asia.
Mandatory for Xiaflex®
Xiaflex® is a prescription medicine for the treatment of a bent penis, Peyronie’s Disease. Because Xiaflex® has risks and benefits you should talk to your doctor for more information. Xiaflex should be administered only by specialists in male urological diseases trained in the correct administration of the product. Do not use for the treatment of Peyronie’s plaques the involve the penile urethra due to the potential risk to this structure. Certain key cautions are possible facture of the penis, patients with coagulation disorders, and possible antibodies to this medicine. The most common adverse reactions are penile swelling, pain and haematoma. If symptoms persist speak to your doctor for further information or refer to the Consumer Medicines Information at www.medsafe.govt.nz. Contains collagenase clostridium histolyticum 900mcg per vial. Healthcare Logistics, Auckland.
c/o Monash Institute of Medical Research Victoria Australia Andrology Australia is an initiative funded by the Australian Government Department of Health and Ageing. This information has been provided for educational purposes only. It is not intended to take the place of a clinical diagnosis or proper medical advice from a fully qualified health professional. Andrology Australia urges readers to seek the services of a qualified medical practitioner for any personal health concerns.
The Priapus Shot® Treatment for Peyronies Disease
The Priapus Shot® treatment for Erectile Dysfunction and
Peyronies Disease Dr M Morunga
Peyronies Disease Dr M Morunga
WHAT IS THE PRIAPUS SHOT®?ade from your own blood, so there are little or no known side effects. It is a concentrated formula of stem-cells and growth factors. PRP injections have been used successfully to help men suffering from erectile dysfunction.Learn More About The P-Shot®. The PRP improves blood flow to the penis, and also stimulates the renewal of erectile tissue, which improves your ability to achieve and maintain an erection. In men with Peyronie’s Disease, PRP injections not only help in ED, they reduce the curvature typical of the disease. |
 |
WHO IS A GOOD CANDIDATE?
Any man with a curved penis who suspects he has, or has been diagnosed with Peyronie’s disease could be a candidate for the P-shot®. Men with Peyronie’s disease who are seeking an alternative to medication or surgery, are particularly good candidates for this non-invasive Peyronie’s disease treatment.
HOW DOES THE P-SHOT® WORK?
The P-shot® is made from your own blood. After taking a small sample of blood, PRP or Platelet Rich Plasma is created using a centrifuge. PRP is filled with healing and growth factors. When injected below the surface of your penis, these healing and growth factors reduce inflammation, and stimulate the growth of new erectile tissue. These effects combine to reduce the scar tissue associated with Peyronie’s disease and to help straighten and/or lengthen your penis.
YOUR P-SHOT® FOR PEYRONIE’S CONSULTATION
During your P-shot® for Peyronie’s Consultation, we will confirm a diagnosis of Peyronie’s disease. We will then determine if you are indeed a good candidate for the P-shot®. We will then explain the P-shot® procedure to you, and answer any questions you may have.
WHAT ARE THE BENEFITS OF THE P-SHOT® FOR PEYRONIE’S?
Over time, men who receive the P-shot® for Peyronie’s Disease should see a gradual reduction of the curvature of the penis. Significant reduction of the curve, and significant increases in length are not uncommon. In order to maximize the straigtening of your penis after the P-shot®, you will likely be instructed to use a vacuum pump for the next 6 weeks. Diet and other lifestyle changes may be suggested to help maximize your results and prevent a recurrence of Peyronie’s disease.
Priapus Shot® Frequently Asked Questions
Biobridge International Scientific Symposium Venice 2014 Priapus Shot®
Erectile Dysfunction and Peyronies Disease
Erectile Dysfunction and Peyronies Disease
HOW FAST CAN I SEE RESULTS?
Straigtening of the curve of Peyronie’s disease takes place gradually over time, and with the help of a pump. You should see results in about six-weeks time.
ARE THERE ANY SIDE EFFECTS?
Since the P-shot® is made from your own blood, there are little or no side effects. Inflammation at the injection sites have been reported on rare occasions.
IS THE P-SHOT® FOR PEYRONIE’S EVER USED WITH OTHER TREATMENTS?
Often we combine the P-shot® with other drug-free Peyronie’s Disease treatments such as the viagra® and a penis pump.
Straigtening of the curve of Peyronie’s disease takes place gradually over time, and with the help of a pump. You should see results in about six-weeks time.
ARE THERE ANY SIDE EFFECTS?
Since the P-shot® is made from your own blood, there are little or no side effects. Inflammation at the injection sites have been reported on rare occasions.
IS THE P-SHOT® FOR PEYRONIE’S EVER USED WITH OTHER TREATMENTS?
Often we combine the P-shot® with other drug-free Peyronie’s Disease treatments such as the viagra® and a penis pump.
WHERE DOES THE INJECTION GO?
A series of 5-6 injections are made just under the skin in the sides of the shaft of your penis, in closest proximity to the scar tissue.
DOES THE PRIAPUS SHOT® HURT?
No, the needles used to deliver the P-shot® are very small, and a local anesthetic is applied first, so the P-shot® is virtually painless.
DOES THE P-SHOT® INCREASE PENIS SIZE?
Since men with Peyronie’s, have a curved penis that may eventually straighten out after the P-shot®, certainly there will be a perceived increase in length. But, even in men without Peyronie’s disease, the P-shot® has been shown to increase penis size.
WILL I NEED TO SEE THE DOCTOR AFTER THE PROCEDURE?
In most cases, a brief follow-up phone call will be needed about four weeks after your treatment. Depending on the outcome of that conversation, you may or may not be asked to come in for further evaluation. Often you may need several P-shot® treatments to achieve the desired results.
HOW LONG DO THE P SHOT® RESULTS LAST?
The lengthening results, and improved erectile function, should last for as long as 18 months. If you have achieved improvement of your Peyronie’s disease, in the absence of a new injury, or if you are not predisposed to the condition, your Peyronie’s should not return.
IS THERE ANYTHING I NEED TO DO AFTER RECEIVING THE P-SHOT®?
After the P-shot ®procedure you will likely be instructed to use a vacuum pump or traction device, twice a day for about 6 weeks. This helps to stretch and straighten the penis to maximum results.
A series of 5-6 injections are made just under the skin in the sides of the shaft of your penis, in closest proximity to the scar tissue.
DOES THE PRIAPUS SHOT® HURT?
No, the needles used to deliver the P-shot® are very small, and a local anesthetic is applied first, so the P-shot® is virtually painless.
DOES THE P-SHOT® INCREASE PENIS SIZE?
Since men with Peyronie’s, have a curved penis that may eventually straighten out after the P-shot®, certainly there will be a perceived increase in length. But, even in men without Peyronie’s disease, the P-shot® has been shown to increase penis size.
WILL I NEED TO SEE THE DOCTOR AFTER THE PROCEDURE?
In most cases, a brief follow-up phone call will be needed about four weeks after your treatment. Depending on the outcome of that conversation, you may or may not be asked to come in for further evaluation. Often you may need several P-shot® treatments to achieve the desired results.
HOW LONG DO THE P SHOT® RESULTS LAST?
The lengthening results, and improved erectile function, should last for as long as 18 months. If you have achieved improvement of your Peyronie’s disease, in the absence of a new injury, or if you are not predisposed to the condition, your Peyronie’s should not return.
IS THERE ANYTHING I NEED TO DO AFTER RECEIVING THE P-SHOT®?
After the P-shot ®procedure you will likely be instructed to use a vacuum pump or traction device, twice a day for about 6 weeks. This helps to stretch and straighten the penis to maximum results.
P Shot® Data Information
Mechanism
The P-Shot® uses Platelet-Rich Plasma (PRP) activated as a Platelet-Rich Fibrin Matrix (PRFM), that harnesses the power of the patients own platelet growth factors to regenerate new connective, vascular and neural tissue. It is a minimally invasive autologous medical treatment used across multiple medical specialties – including cosmetic rejuvenation.
Safety
There have been no serious long term effects found with PRP when administered appropriately with an FDA approved kit. A recent retrospective study in the Investigative Clinical Urology, Ethan 2018, concluded that PRFM injections for Erectile Dysfunction (ED) and Peyronie’s Disease (PD) are feasible and safe (1)
Providers
The P-Shot® is a trademarked procedure created by Dr Charles Runels. All global providers are registered members of the Cellular Medicine Association which includes urologists, surgeons, cosmetic physicians and general practitioners (2).
Patient Satisfaction Rates.
A retrospective study of 1220 patients by Kumar CS; “Combined Treatment of Injecting Platelet Rich Plasma With Vacuum Pump For Penile Enlargement”; J Sex Med 2016, 11, 174, concluded that penile length and girth enhancement using PRP and Vacuum Device for patients suffering from small penis, severe ED, significant shortening with or without Peyronies disease is a safe cheap effective procedure that can be performed in an outpatient department. With erection satisfaction rates of 70% reported (3). Important variables such as patient medical history, presence chronic illness, medications-anti platelet therapy, lifestyle-smoking, type of PRP kits, harvesting technique, quality of PRP, doctor skill and patient expectations are contributing factors towards patient satisfaction and dissatisfaction rates (2a).
Demographics
In New Zealand there are more than 1 in 3 men who suffer from erectile dysfunction in their lifetime (4,5) the majority of whom present with mild-to-moderate erectile symptoms, which worsen with age (4). We recommend that any complicated cases that have not previously been investigated be referred to the appropriate clinicians such as an urologist before proceeding with any treatment.
References:
1) Ethan L Matz, Amy M Pearlman, Ryan P Terlecki; Investig Clin Urol 2018 Jan; 59 (1): 61-65
2) Website www.priapusshot.com/members/directory and 2a) Website www.priapusshot.com
3) Kumar CS; “Combined Treatment of Injecting Platelet Rich Plasma With Vacuum Pump For Penile Enlargement”; J Sex Med 2016, 11, 174
4) Quilter M, Hodges L, von Hurst, P, et al; “Male Sexual Function In New Zealand: A Population-Based Cross-Sectional Survey Of The Prevalence Of Erectile Dysfunction In Men Aged 40-70 Years”; J Sex Med 2017; 14:928-936
5) Berrada S, Kadri N, Mechackra-Tahiri S, Nejjari C; “Prevalence Of Erectile Dysfunction And Its Correlates; A Population-Based Study In Morocco”; Int J of Impotence Res 2003; 15:S3-S7
6) Virag R; “A New Treatment Of Lapeyronie’s Disease By Local Injections Of Plasma Rich Platelets (PRP) and Hyaluronic Acid . Preliminary Results.” E-Memoires de l’Academie Nationale de Chirurgie 2014; 13(3):96-100
7) Virag R; “Evaluation Of The Benefit Of Using A Combination Of Autologous Platelet-Rich Plasma and Hyaluronic Acid For The Treatment Of Peyronie’s Disease”; Sex Health Issues 2017 1(1):1-8
The P-Shot® uses Platelet-Rich Plasma (PRP) activated as a Platelet-Rich Fibrin Matrix (PRFM), that harnesses the power of the patients own platelet growth factors to regenerate new connective, vascular and neural tissue. It is a minimally invasive autologous medical treatment used across multiple medical specialties – including cosmetic rejuvenation.
Safety
There have been no serious long term effects found with PRP when administered appropriately with an FDA approved kit. A recent retrospective study in the Investigative Clinical Urology, Ethan 2018, concluded that PRFM injections for Erectile Dysfunction (ED) and Peyronie’s Disease (PD) are feasible and safe (1)
Providers
The P-Shot® is a trademarked procedure created by Dr Charles Runels. All global providers are registered members of the Cellular Medicine Association which includes urologists, surgeons, cosmetic physicians and general practitioners (2).
Patient Satisfaction Rates.
A retrospective study of 1220 patients by Kumar CS; “Combined Treatment of Injecting Platelet Rich Plasma With Vacuum Pump For Penile Enlargement”; J Sex Med 2016, 11, 174, concluded that penile length and girth enhancement using PRP and Vacuum Device for patients suffering from small penis, severe ED, significant shortening with or without Peyronies disease is a safe cheap effective procedure that can be performed in an outpatient department. With erection satisfaction rates of 70% reported (3). Important variables such as patient medical history, presence chronic illness, medications-anti platelet therapy, lifestyle-smoking, type of PRP kits, harvesting technique, quality of PRP, doctor skill and patient expectations are contributing factors towards patient satisfaction and dissatisfaction rates (2a).
Demographics
In New Zealand there are more than 1 in 3 men who suffer from erectile dysfunction in their lifetime (4,5) the majority of whom present with mild-to-moderate erectile symptoms, which worsen with age (4). We recommend that any complicated cases that have not previously been investigated be referred to the appropriate clinicians such as an urologist before proceeding with any treatment.
References:
1) Ethan L Matz, Amy M Pearlman, Ryan P Terlecki; Investig Clin Urol 2018 Jan; 59 (1): 61-65
2) Website www.priapusshot.com/members/directory and 2a) Website www.priapusshot.com
3) Kumar CS; “Combined Treatment of Injecting Platelet Rich Plasma With Vacuum Pump For Penile Enlargement”; J Sex Med 2016, 11, 174
4) Quilter M, Hodges L, von Hurst, P, et al; “Male Sexual Function In New Zealand: A Population-Based Cross-Sectional Survey Of The Prevalence Of Erectile Dysfunction In Men Aged 40-70 Years”; J Sex Med 2017; 14:928-936
5) Berrada S, Kadri N, Mechackra-Tahiri S, Nejjari C; “Prevalence Of Erectile Dysfunction And Its Correlates; A Population-Based Study In Morocco”; Int J of Impotence Res 2003; 15:S3-S7
6) Virag R; “A New Treatment Of Lapeyronie’s Disease By Local Injections Of Plasma Rich Platelets (PRP) and Hyaluronic Acid . Preliminary Results.” E-Memoires de l’Academie Nationale de Chirurgie 2014; 13(3):96-100
7) Virag R; “Evaluation Of The Benefit Of Using A Combination Of Autologous Platelet-Rich Plasma and Hyaluronic Acid For The Treatment Of Peyronie’s Disease”; Sex Health Issues 2017 1(1):1-8
