Combination Therapy (in the Treatment of Peyronie’s Disease)

  • Gianni PaulisEmail author


Multimodal therapy (MMT) is a term coined in the last century and derived from psychotherapy. MMT means that there are multiple modalities of each patient that should be addressed when both identifying and treating a psychological disorder.

In our different field of action, the concept may be applied in order to achieve a better therapeutic outcome. Similarly, we can devise a treatment plan that includes several therapeutic substances and/or treatment modalities in order to achieve greater results than each single drug or treatment modality. In this chapter are presented the most important studies where a combination therapy for Peyronie’s disease (PD) has been proposed and implemented. Various combinations of therapies were listed and presented as potential treatments for PD. The goal of combination therapy is to combine different mechanisms of action to enhance improvement in signs and symptoms of PD.


Peyronie’s disease Peyronie’s disease treatment Combined therapy Penile injection Antioxidants 


  1. 1.
    Lazarus AA (1989) The practice of multimodal therapy: systematic, comprehensive, and effective psychotherapy. Johns Hopkins University Press, BaltimoreGoogle Scholar
  2. 2.
    Madsen HV (1948) Combination promin and streptomycin therapy for tuberculosis. Dis Chest 14(6):850–852CrossRefPubMedGoogle Scholar
  3. 3.
    Kristenson A (1950) Treatment of cavernous pulmonary tuberculosis with a combination of chemotherapy and antibiotics. Acta Tuberc Scand Suppl 26:15–25PubMedGoogle Scholar
  4. 4.
    Hetrick C, Ras R, Turri M (1970) Combined rifampicin-ethambutol therapy of resistant pulmonary tuberculosis. Effectiveness of various rifampicin doses in combination with ethambutol. Dtsch Med Wochenschr 95(36):1830–1833 [Article in German]CrossRefPubMedGoogle Scholar
  5. 5.
    Gumbo T, Pasipanodya JG, Wash P et al (2014) Redefining multidrug-resistant tuberculosis based on clinical response to combination therapy. Antimicrob Agents Chemother 58(10):6111–6115CrossRefPubMedCentralPubMedGoogle Scholar
  6. 6.
    Shapiro DM (1952) Combination chemotherapy with 8-azaguanine and sex hormones on a mouse mammary carcinoma. Cancer Res 12(10):713–715PubMedGoogle Scholar
  7. 7.
    Shapiro DM, Gellhorn A (1941) Combination of chemical compounds in experimental cancer therapy. Cancer Res 11:35–41Google Scholar
  8. 8.
    Skipper HE (1949) Carbamates in the chemotherapy of leukemia. V. Observation of a possible antileukemic synergism between Orethan and Methylbis (3-chloroethyl)-amine. Cancer 2:475–479CrossRefPubMedGoogle Scholar
  9. 9.
    Samadi N, Ghanbari P, Mohseni M et al (2014) Combination therapy increases the efficacy of docetaxel, vinblastine and tamoxifen in cancer cells. J Cancer Res Ther 10(3):715–721PubMedGoogle Scholar
  10. 10.
    Ferulano O (1955) Effect of circular electrolysis combined with medical treatment (wydase and vitum E) in delayed plastic induration of penis; hypothesis on etiology and pathogenesis and clinical aspects. G Ital Chir 11(9):1049–1061 [Article in Italian]PubMedGoogle Scholar
  11. 11.
    Burford EH, Burford CE (1957) Combined therapy for Peyronie’s disease. J Urol 78(3):265–268PubMedGoogle Scholar
  12. 12.
    Kierkegaard E, Nielsen B (1979) Peyronie’s disease treated with K-para-aminobenzoate and vitamin E. Ugeskr Laeger 141(30):2052–2053 [Article in Danish]PubMedGoogle Scholar
  13. 13.
    Novak GI (1984) Conservative treatment of Peyronie’s disease with vitamin E and hydrocortisone. Vestn Dermatol Venerol 8:63–68, Article in RussianPubMedGoogle Scholar
  14. 14.
    Pastorini S, Marino G, Brigato R et al (1991) The therapy of plastic penile induration using superoxide dismutase per os and injection combined with vasoactive intracavernous pharmacotherapy. Minerva Urol Nefrol 43(2):75–78 [Article in Italian]PubMedGoogle Scholar
  15. 15.
    Lamprakopoulos A, Zorzos I, Lykourinas M (2000) The use of betamethasone and Hyaluronidase injections in the treatment of Peyronie’s disease. Scand J Urol Nephrol 34(6):355–360CrossRefPubMedGoogle Scholar
  16. 16.
    Cavallini G, Biagiotti G, Koverech A et al (2002) Oral propionyl-l-carnitine and intraplaque verapamil in the therapy of advanced and resistant Peyronie’s disease. BJU Int 89(9):895–900CrossRefPubMedGoogle Scholar
  17. 17.
    Prieto Castro RM, Leva Vallejo ME, Regueiro Lopez JC et al (2003) Combined treatment with vitamin E and colchicine in the early stages of Peyronie’s disease. BJU Int 91(6):522–524CrossRefPubMedGoogle Scholar
  18. 18.
    Cakan M, Demirel F, Aldemir M et al (2006) Does smoking change the efficacy of combination therapy with vitamin E and colchicines in patients with early-stage Peyronie’s disease? Arch Androl 52(1):21–27CrossRefPubMedGoogle Scholar
  19. 19.
    La Pera G, Pescatori ES, Calabrese M, SIMONA Study Group et al (2001) Peyronie’s disease: prevalence and association with cigarette smoking. A multicenter population-based study in men aged 50–69 years. Eur Urol 40(5):525–530CrossRefPubMedGoogle Scholar
  20. 20.
    Candebat Montero LH, Miranda Reyes PL, Díaz García F et al (2008) Peyronie’s disease: treatment with interferon and laser. Arch Esp Urol 61(3):413–423 [Article in Spanish]CrossRefPubMedGoogle Scholar
  21. 21.
    Taylor FL, Levine LA (2008) Non-surgical therapy of Peyronie’s disease. Asian J Androl 10(1):79–87CrossRefPubMedGoogle Scholar
  22. 22.
    Cortés-González JR, Glina S (2010) Conservative treatment of Peyronie’s disease: colchicine vs. colchicine plus vitamin E. Actas Urol Esp 34(5):444–449 [Article in Spanish]CrossRefPubMedGoogle Scholar
  23. 23.
    Kuehhas FE, Weibl P, Georgi T et al (2011) Peyronie’s disease: nonsurgical therapy options. Rev Urol 13(3):139–146PubMedCentralPubMedGoogle Scholar
  24. 24.
    Larsen SM, Levine LA (2012) Review of non-surgical treatment options for Peyronie’s disease. Int J Impot Res 24(1):1–10CrossRefPubMedGoogle Scholar
  25. 25.
    Abern MR, Larsen S, Levine LA (2012) Combination of penile traction, intralesional verapamil, and oral therapies for Peyronie’s disease. J Sex Med 9(1):288–295CrossRefPubMedGoogle Scholar
  26. 26.
    Halal AA, Geavlete P, Ceban E (2012) Pharmacological therapy in patients diagnosed with Peyronie’s disease. J Med Life 5(2):192–195PubMedCentralPubMedGoogle Scholar
  27. 27.
    Levine LA (2013) Peyronie’s disease: contemporary review of non-surgical treatment. Trans Androl Urol. 2(1). Available at:
  28. 28.
    Favilla V, Russo GI, Privitera S et al (2014) Combination of intralesional verapamil and oral antioxidants for Peyronie’s disease: a prospective, randomised controlled study. Andrologia 46(8):936–942CrossRefPubMedGoogle Scholar
  29. 29.
    Paulis G, D’Ascenzo R, Nupieri P et al (2012) Effectiveness of antioxidants (propolis, blueberry, vitamin E) associated with verapamil in the medical management of Peyronie’s disease: a study of 151 cases. Int J Androl 35(4):521–527CrossRefPubMedCentralPubMedGoogle Scholar
  30. 30.
    Paulis G, Cavallini G, Brancato T et al (2013) Peironimev-Plus® in the treatment of chronic inflammation of tunica albuginea (Peyronie’s disease). Results of a controlled study. Inflamm Allergy Drug Targets 12(1):61–67CrossRefPubMedGoogle Scholar
  31. 31.
    Paulis G, Brancato T, D’Ascenzo R et al (2013) Efficacy of vitamin E in the conservative treatment of Peyronie's disease: legend or reality? A controlled study of 70 cases. Andrology 1(1):120–128CrossRefPubMedGoogle Scholar
  32. 32.
    Paulis G, Cavallini G, De Giorgio G et al (2013) Long-term multimodal therapy (verapamil associated with propolis, blueberry, vitamin E and local diclofenac) on patients with Peyronie’s disease (chronic inflammation of the tunica albuginea). Results of a controlled study. Inflamm Allergy Drug Targets 12(6):403–409CrossRefPubMedGoogle Scholar
  33. 33.
    Paulis G, Pirozzi Farina F et al (2014) Pentoxifylline Associated with Other Antioxidants (Multimodal Therapy) on Patients with Peyronie’s Disease. Results of a Controlled Study. Andrology Open Access 3:123Google Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Andrological ServiceRegina Apostolorum HospitalRomeItaly
  2. 2.Castefidardo Medical TeamRomeItaly

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