Is it beneficial to achieve erection and masturbate in the early stages of Peyronies disease?

Dr. Herazy,

I spoke with you on the phone this evening, Friday May 11th.  I sincerely thank you for taking the time to talk with me.  Much appreciated.  I will be ordering your book as my first step.

If I operate under the assumption that my situation is in fact Peyronie's disease, it would be safe to assume since my symptoms of curvature and pain started about a month ago that I am in the initial stages of the syndrome.   I have two questions for you:

1. Is it beneficial to achieve erection and masturbate in this stage? My thought is that this may have some benefit in protecting from scarring, similar to prescribed rehab after a knee surgery. In that example the patient manipulates the joint frequently to break up formed and forming scar tissue. Would this be useful?

2. Do you recommend or discourage the use of Viagra and the other similar drugs in this period?  Could they help or hurt healing?

Thanks again for your time.  I will keep you posted!

R. Brown

 

Greetings R.

As you recall, I mentioned that there are often many irregularities and inconsistencies in the way Peyronies disease will present itself; it is rare to find someone with a classic text book presentation.  Since your particular symptoms and history does not strongly suggest that you have PD, and only a few a small part that does, I suggest you consult with a second urologist to confirm one way or the other your actual diagnosis. 

That masturbation might be beneficial for Peyronies' disease because exercise of joint after surgery is a standard therapy, is a flawed comparison.  What you are proposing would not be much different than watching movies after eye surgery, smelling flowers after nose surgery or listening to music after ear surgery.   In Peyronie's disease the lesion or problematic tissue is relatively passive or non-functional relative to sexual activity.  Even though  it is obviously the  primary structure that is involved in sexual activity and it certainly gets involved, in my opinion there is limited and minimal direct therapeutic benefit to masturbation for Peyronie's disease.   Having said that I think there is considerable secondary or indirect benefit.   Masturbation is helpful not only from an emotional basis, but also due to the increased blood circulation that occurs during any type of sexual activity.   I doubt that frequent or occasional masturbation would make a great difference to your eventual recovery, one way or the other, but if it feels good and it benefits you even a small amount then that is probably reason enough to do it. 

While exercise to rehabilitate a damaged joint and weak muscles are obviously appropriate and necessary therapy for a bony articulation that is meant to move and muscles that are meant to contract, none of this applies to the corpora cavernosa, corpora spongiosum or tunica albuginea of the penile shaft. 

If I have not stated the point clearly enough, allow me another round at it.  While there might be small and indirect benefit to masturbation if you have any stage of Peyronie's disease, I am sure the direct therapeutic benefit is only minimal.  I get the sense from your question that you had the idea you could "masturbate your way out of PD."   To the extent this is what you had hoped, the answer is no.    

All sexual activity, especially masturbation,  for a man with Peyronie's disease should be gentle, easy and non-traumatic in every way possible.  A critical part of being as gentle and easy on yourself  is to use an above average amount of personal lubrication to avoid abuse to the involved tissue.  Easy does it.  If it hurts, even a little, stop doing and never repeat whatever does not feel pleasant to you.  One of the worse things you can do for yourself would be to reduce or alter your usual and customary sexual activity simply because you have Peyronie's disease.  Many men do this, and it sets up an attitude of defeat and hopelessness that is not beneficial for eventual recover.   Go at it, sir, but be careful.

I can tell you a long list of sad stories related to me by teenage boys who developed Peyronies after injuring themselves while using rough and exotic masturbation practices; more 14 and 15 year old virgin boys than you would imagine, who will never have intercourse in their lives if they follow the standard medical advice of "do nothing until I say it is time for Peyronie's surgery."

I have written extensively about the frequent situations in which the use of the PDE5 inhibitor drugs (Viagra, Cialis, Levitra) can precipitate injury to the delicate tunica albuginea of the shaft and lead to Peyronie's disease.  You can search the archives for these articles, but a few are "Peyronie's disease plaque, Viagra, Cialis, Levitra and blood supply" and "Viagra, Cialis, and Levitra use with Peyronie's disease," and" Viagra Peyronie's disease connection."

Please let me know if I can help you in any other way.  TRH

Peyronie’s Disease Treatment Via Direct Drug Injection

Injections can cause Peyronie’s disease

Peyronie’s disease treatment using drug injection into the delicate tunica albuginea of the penis is a medical therapy that is fast loosing favor for treatment of the Peyronie's penis.  One of the reasons is the lack of good results, the other is that it has been shown that injections can cause or aggravate Peyronie’s disease in many cases.

I have personally communicated with hundreds of men whose Peyronies started after a series of penile injections that were undertaken for a variety of reasons.  It appears the drug is not so much the issue that causes injury to the tunica membrane, but the repeated penetration and trauma that causes the scar material that eventually starts a Peyronies problem.   However, it has also been shown that the presence of certain drugs can cause a chemical irritation to the tunica albuginea.  So in this regard, drug injections could easily represent a double threat of injury to the tunica that results in Peyronie’s disease.

Peyronie's treatment – "First, do no harm"

This blog post about Peyronie’s disease treatment using direct drug injections (Verapamil, cortisone, etc.) should hit home for a large number of you.  Many men have undergone painful drug injections into the penis because their medical doctor thought it was worth the effort, and only found themselves with a new problem or worsening of their original Peyronie's disease.

First I will simply copy an article, “Extracorporeal shock-wave therapy in the treatment of Peyronie's disease.”  This research discussion is essentially about Extracorporeal Shock Wave Therapy, ESWT (or ESWLas they call it here).  

What is important to note in our particular discussion is the area I have highlighted for emphasis.  This form of therapy has been fairly well abandoned by a large percent of doctors who used it for many years since these injections seem to cause more problems than it helps. The reason this information about ESWT (or ESWL) is included in this article about penile injections is that these Russian physicians make a very interesting comment while discussing ESWT that underscores the damage created by injections (of any kind) into the tunica albuginea.

[Article in Russian]

Ne?mark AI, Astakhov IuI, Sidor MV.

The authors analyse the results of treatment of 28 patients with Peyronie's disease using extracorporeal shock-wave lithotripsy (ESWL) performed on Dornier U15 lithotriptor. A total of 2-6 sessions were made, maximal number–12. The efficacy was controlled by clinical indices and ultrasonic investigation (Doppler mapping of the blood flow). ESWL proved to be efficient in the treatment of Peyronie's disease (PD), primarily, in patients with early disease before appearance of severe fibroplastic alterations. Less plaque vascularization by energetic Doppler mapping due to ESWL is an important diagnostic criterion of PD treatment efficacy. Conservative treatment is not indicated in marked deformities and plaque calcification, erectile dysfunction. Moreover, any injection into the tunica albuginea, especially complicated by hematomas (deep tissue bruising) may be a damaging factor which triggers fibrous inflammation. Such patients should be treated surgically. If the patient is interested in immediate results or is not interested in continuation of sexual life, the treatment is ineffective. Thus, ESWL is an effective, safe method of PD treatment but requires further study and accumulation of clinical experience.

It seems that the problems penile injections can cause is not that necessarily about the drug that is injected into the tunica, but the needle itself that is used to deliver the drug. An injection to deliver any drug, or sterile water, can cause injury to this delicate membrane.  This sets off an inflammatory response that can result in significant Peyronie’s disease plaque or scar tissue formation for men who as so predisposed.   Doing this once can be risky.  Doing this up to a dozen times over a few months, as is often the recommended course of therapy, just multiples the opportunity for injury to mount on top of injury.

This Russian research team offers the opinion that the effects of such injection into the penile shaft causes such significant plaque development, that surgery is the best treatment option for the damage that it can cause.   Obviously, I do not agree with that, since surgery can also cause more scar development. Their conclusion is that they find men who receive these injections often eventually are rewarded with a disturbed and discontinued sexual life.

Growing concern about injections for Peyronie's disease treatment

This idea is brought to your attention to demonstrate there are many in the medical community who agree with the same position that I have taken for many years now.  These doctors and I contend it is inherently risky, in fact, dangerous, to stick needles repeatedly into the penis for Peyronie’s disease treatment. Their  logic concludes that any treatment that can start or aggravate the very problem it is attempting to treat, is not much of a treatment.

It is unfortunate that the medical community turns a blind eye to the direct observation of poor results, serious irritation of the tunica, and the solid logic that reputes injections as a form of Peyronie’s cure.  Those who continue to inject their Peyronie’s disease patients, and bring these men farther down the road toward greater plaque development, must be desperate to look useful or just ignorant of how Peyronie’s disease often develops.  It is so common for medical doctors to think only in terms of medicine and surgery, notwithstanding the tragedy that can often result from their limited thinking.

The Peyronie's treatment concept of using non-invasive methods to increase the healing response of the body is a safer and more trustworthy Peyronie’s disease treatment than some of the aggressive medial schemes being promoted today.

Peyronie’s disease treatment via direct drug injection

Injections can injure delicate tunica albuginea, leading to Peyronie's disease

This blog post about Peyronie’s disease treatment using direct drug injections (Verapamil, cortisone, etc.) should hit home for a large number of you. Many men have undergone painful drug injections into the penis because their medical doctor thought it was worth the effort, and only found themselves worse for their effort.

First I will simply copy an article, “Extracorporeal shock-wave therapy in the treatment of Peyronie's disease.” This research discussion is essentially about Extracorporeal Shock Wave Therapy, ESWT (or ESWL as they call it here). This article comes from www.pubmed.gov under the reference number PMID: 15114750 [PubMed – indexed for MEDLINE].

What is important to note in our particular discussion is the area I have highlighted for emphasis. You will note from an earlier post about ESWT in Peyronie’s Disease Treatment Forum blog, this form of therapy has been fairly well abandoned by a large percent of doctors who used it for many years since these injections seem to cause more problems than it helps. The reason this information about ESWT (or ESWL) is included in this article about penile injections is that these Russian physicians make a very interesting comment while discussing ESWT that underscores the damage created by injections (of any kind) into the tunica albuginea.

[Article in Russian]

Ne?mark AI, Astakhov IuI, Sidor MV.

The authors analyze the results of treatment of 28 patients with Peyronie's disease using extracorporeal shock-wave lithotripsy (ESWL) performed on Dornier U15 lithotriptor. A total of 2-6 sessions were made, maximal number–12. The efficacy was controlled by clinical indices and ultrasonic investigation (Doppler mapping of the blood flow). ESWL proved to be efficient in the treatment of Peyronie's disease (PD), primarily, in patients with early disease before appearance of severe fibroplastic alterations. Less plaque vascularization by energetic Doppler mapping due to ESWL is an important diagnostic criterion of PD treatment efficacy. Conservative treatment is not indicated in marked deformities and plaque calcification, erectile dysfunction. Moreover, any injection into the tunica albuginea, especially complicated by hematomas (deep tissue bruising) may be a damaging factor which triggers fibrous inflammation. Such patients should be treated surgically. If the patient is interested in immediate results or is not interested in continuation of sexual life, the treatment is ineffective. Thus, ESWL is an effective, safe method of PD treatment but requires further study and accumulation of clinical experience.

It seems that the problem penile injections can cause is not necessarily about the drug that is injected into the tunica, but the needle itself that is used to deliver the drug. An injection to deliver any drug – or sterile water – can cause injury to this delicate membrane. This sets off an inflammatory response that can result in significant Peyronie’s disease plaque or scar tissue formation for men who as so predisposed. Doing this once can be risky. Doing this up to a dozen times over a few months, as is often the recommended course of therapy, just multiples the opportunity for injury to mount on top of injury.

This Russian research team offers the opinion that the effects of such injection into the penile shaft causes such significant Peyronie's plaque development, that surgery is the best treatment option for the damage that it can cause. Obviously, I do not agree with that, since Peyronie's surgery can also cause more scar development. Their conclusion is that they find men who receive these injections often eventually are rewarded with a disturbed and discontinued sexual life.

This idea is brought to your attention to demonstrate there are many in the medical community who agree with the same position that I have taken for many years now. These doctors and I contend it is inherently risky, in fact, dangerous, to stick needles repeatedly into the penis for Peyronie’s disease treatment. Their logic concludes that any treatment that can start or aggravate the very problem it is attempting to treat, is not much of a treatment.

It is unfortunate that the medical community turns a blind eye to the direct observation of poor results, serious irritation of the tunica, and the solid logic that reputes injections as a form of Peyronie’s treatment. Those who continue to inject their Peyronie’s disease patients, and bring these men farther down the road toward greater plaque development, must be desperate to look useful or just ignorant of how Peyronie’s disease often develops. It is so common for medical doctors to think only in terms of medicine and surgery, notwithstanding the tragedy that can often result from their limited thinking.

The PDI concept of using non-invasive methods to increase the healing response of the body is a safer and more trustworthy Peyronie’s disease treatment than some of the aggressive medial schemes being promoted today. For more information about the Alternative Medicine treatment philosophy for care of PD, please go to the PDI website.

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