Combination Nonsurgical Therapy

Abstract

Over the years, physicians have been searching for an effective way to treat Peyronie’s disease (PD). This disorder remains poorly understood. As a result, there is no straightforward reliable therapy. When it is felt that medical therapy is in order, it is best started at the early stages of acute inflammation, when the therapy can potentially prevent the evolution of fibrosis. A variety of combined treatments have been tried in the past appearing to give better results than monotherapy. Various types of energy transfer, including shockwave therapy, orthovoltage radiation, ultrasound, laser therapy, and shortwave diathermy, have been used for PD. The best reported clinical results have been obtained by combining laser therapy with shockwave therapy, especially for pain resolution. Treatment outcomes concerning reducing penile curvature and plaque resorption have been disappointing. Published reports have demonstrated the best results of combination therapy with shockwave therapy and intralesional injection of verapamil as this approach appears not only to reduce pain but also to improve penile deformity. This chapter reviews the results of nonsurgical combination therapy in the treatment ofPD.