What Peyronie's treatment plan would you recommend for me with an enlarged prostate?

I have used your basic plan in 2010 and after that I discontinued since I was able to get erections and intercourse was not painful. Later I have been diagnosed with an enlarged prostate but PSA is normal. Now I have irritating and burning pain after ejaculation for many hours and my penis appears to become short although the curvature is not significant. The amount of semen is also very little. I am 47 years old. Never used Viagra or any other enhancing drugs.

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I am deficient on Vitamin D and taking an Omega supplement which also has Vitamin E.   What plan you would recommend for me and can you provide me details of medication in each plan. It was listed in this site but could not find now.

R Venkat

Greetings R,

I suspect that you did not correctly or completely finish your course of initial care and that this is the reason some of your symptoms of small curvature has come back.  Since you discontinued care because your erections improved and intercourse was no longer painful, I suspect you made a fundamental mistake in understanding how the PDI treatment should be used.   It appears to me you did not monitor the condition of your scar in terms of reduction of the size, shape, density and surface features of your Peyronie's disease scar to know for a fact that your true problem was gone.  While it is good your pain improved and your erection quality improved, that is not a good way to determine success or failure in treatment.  I also suspect that you got a small reduction of your scar (enough to make intercourse less painful and erections stronger) but that there was more work left to be done to reduce the scar further that you did not do.

Many of your current complaints could be due to the prostate enlargement you mention; you should discuss this with your doctor.  For this I suggest that in addition to using the medication he has prescribed for you, that you consider using multiple vitamin supplement that will supply all the nutrients that you need for your general health, plus special nutrition and herbal support for the prostate gland; it is called Prosta-Support.   Additionally, it would be good for you to talk to your doctor about performing a simple and economical prostate massage on yourself a few times a week using the Aneros prostate massager.

You should consider using at least a medium Peyronies treatment plan, and even a large Peyronie's treatment plan if it is in your budget because it is larger and more diverse, to help your body completely eliminate the remainder of your Peyronie's scar.  TRH

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Is it possibile for Viagra, or any other medication, to cause Peyronie disease?

Is anyone doing research on the possibility of Viagra causing Peyronie disease or any other type of medication causing this disease?  Mine seems to have started after I took Viagra . Thank you,  Floyd Mathis

 

Greetings Floyd,

Sorry to hear of your problem with Peyronie's disease.

Yes, there is growing evidence that Viagra, Cialis and Levitra (all the PDE5 inhibitor drugs) can cause Peyronie's disease in some men.  I have reported this and written about this observation for many years now.  You can read more about this topic in these posts from the PDI website:  Viagra Peyronie's disease connection and Viagra, Cialis and Levitra Use with Peyronie’s Disease and Peyronie’s Disease Plaque, Viagra, Cialis, Levitra, and Blood Supply .  There are more articles that are available but I think you will get the idea from these. 

The basic way the injury happens that leads to the start of Peyronie's disease is from "over inflation" that damages the internal tissue of the penis called the tunica albuginea.

I was talking to a man the other day from Australia whose PD started from just a single use of one of these PDE5 drugs. He told me that he developed an erection that was so hard and large that he was scared what might happen to him.  He said he thought he might explode.  Obviously that was the last and only time he took any drug like that.  About two months later he had three internal Peyronie's plaques and a curved penis of 45 degrees.  Because he did not have any sexual activity for months before that event or after it he is positive it was the drug that injured him. 

He went to his medical doctor who told him that this sometimes happens to men.  You will notice that there is a caution on inside drug product information that warns that men with PD should not use these PDE5 drugs.  

What strikes me as especially careless and inappropriate is that there are medical doctors who actually prescribe Viagra, Cialis and Levitra to men who already have Peyronie's disease to help them have an erection when they show signs of erectile dysfunction.

Yes, there are other drugs that are said to be associated with or to cause Peyronie's disease.  The common list includes beta blockers used for heart problems and all of the statin drugs used to lower cholesterol.    

I suggest that you review some of the Alternative Medicine treatment ideas on the PDI website to learn how you can use Peyronie's natural treatment to help yourself correct this problem.  Please let me know if there is anything I can do to help you.  TRH 

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

Is there a connection between using Cialis and Peyronies disease?

Is there a connection between using Cialis and Peyronies disease? The reason being is because I had no signs of the disease developing. I woke up one morning to find the scar/plaque on my penis when I went to the bathroom. Overall I took about 13 pills over 6-7 weeks, only taking one at a time. My doctor examined me and confirmed that I have it but did not offer anything solutions or why it happened. He did say he was surprised that it just came on as fast as it did which was like overnight for me.  I know my body and I was completely surprised.

Greetings,

Cialis is a member of group of drugs called PDE5 inhibitors, used to treat symptoms of erectile dysfunction (ED). Other members are Viagra and Levitra.

Yes, there definitely appears to be a connection between using Cialis and Peyronies disease.   Over the years I have encountered many men whose Peyronie's disease started after using just one dose of a PDE5 inhibitor.  There are many lawsuits pending in this regard.

Here are a few of the posts I have written about this subject over the years: Peyronie's disease plaque, Viagra, Cialis, Levitra and blood supply, and Peyronie's disease treatment and Viagra, Cialis and Levitra; there are others if you look further on the website.  TRH

Can Avodart increase or aggravate Peyronies disease symptoms?

Can the drug Avodart increase or aggravate Peyronies symptoms?   Currently taking this medication for an enlarged prostate.

Greetings,

There is growing concern about Avodart use leading to or aggravating Peyronie's disease.   Currently some statistics and experts say yes, and others say no.  

The drug most commonly reported to cause Peyronie's disease as a side effect is Viagra, and the next common is Levitra. Both of these are PDE5 inhibitors used to treat sexual dysfunction.   A short distance down this list, about the 7th most common drug reported to the FDA to cause Peyronie's disease symptoms is Avodart. 

From common experience I think we have all seen the medical profession refuse to acknowledge that a drug is causing too many bad side effects, until public pressure from growing evidence becomes overwhelming and the drug is reluctantly removed from the marketplace.  The drug goes one day from being great-fine-perfect-no problem-don't get excited, and the next day it is gone because someone finally does the right thing.  

I do not have a straight answer to your question.  I do not know if Avodart causes or aggravates Peyronies symptoms.  However, when you see dark clouds on the horizon and you hear distant thunder, you should begin to question the expert weather forecast for bright skies and sunshine.   

You should talk to your prescribing doctor about your concern.  Make no changes to your prostate treatment without his/her knowledge.  TRH       

What are your thoughts about Peyronie’s disease after second prostate biopsy?

I never had a problem with my penis til the last year. I am 63 yo, WM who has had two prostate biopsies over the last 6 yrs…each biopsy came back negative. After this second biopsy I notice my cock bends towards my tummy when erect and that it has lost about 3/4 of a inch…this is substantiated by my wife. Also, I have trouble obtaining and maintaining a erection even with the use of ED drugs.  Please help with your thoughts.

Thank you,

Peter Martin

Greetings Peter,

Your upward distortion and lost of penile length suggest the possibility of Peyronie's disease.  I suggest you have yourself examined to see if that is true or not.  I also suggest you go to a urologist different than the one who did the biopsies to assure a more non-biased and straightforward discussion.

Many men with Peyronie's disease develop it as a result of repeated catheterization associated with prostate surgery and biopsy.  Please refer to "Possible Peyronie's Cause:  Catheter and Cystoscopic Trauma."   Much abuse to the shaft and urethra can and does take place during these procedures and this could lead to Peyronies disease developing; since this traumatic effects tend to accumulate, all the more so.  

Further, repeated use of ED drugs (PDE5 inhibitors like Viagra, Cialis and Levitra) can also lead to a curved penis.  For more information you should read "Peyronies and Viagra" and "Peyronie's Disease Plaque, Viagra, Cialis, Levitra and Blood Supply."

There are some good things that Alternative Medicine can offer you in the way of Peyronie's treatment.  Please read the PDI website for information on a way out of using more drugs and procedures that can make your problem worse than it is now.   TRH  

Herbal products to help with ED sex problems associated with Peyronie’s disease?

I believe I got PD using ED drugs been married 30 yrs & need some erection help. Have stopped using the drugs, can you suggest something herbal I can use to replace them. Thanks Dave

Greetings Dave,

What you report is rather common.  I have communicated with hundreds of men who tell me their Peyronie's disease and sex started after using PDE5 inhibitor drugs (Viagra, Cialis, Levitra); this can happen after just one use or repeated uses.  For more information see Peyronie's disease and Viagra, Levitra and Cialis and Peyronie's treatment and Cialis.

If you go to the PDI shopping cart and scroll about 3/4 the way down until you see BetterMAN and about 5-6 other sex stimulant products. The most important of the group is a product called Stimulin. You would definitely want to include Stimulin with whatever else you use.  

All of these herbal products are much more gentle than your drugs and will not worsen your PD problem.   Many men use them while undergoing their natural Peyronie's treatment plan.  TRH

What are the chances my Peyronies will stabalize soon?

i am a healthy 50 yr old who has been diagnosed with Peyronie's disease about 14 months ago.  I've had a dent about 1 inch from the base approx.2 inches long during erection.  I thought it was stabilizing but seems to be getting slightly worse, moving towards the head.  I now think I'm starting to get some ED.  No treatment except vitamin E.  Starting to stress,what are your suggestions on treatment?   What are the chances this will stabilize soon?  Should i expect this to get worse?  Are the ED drugs (Viagra) a good idea to use?

Greetings,

You are asking several questions, most of which are answered many places within the PDI website.  I suggest that if you wish to learn more about PD you spend a little time reading what is here for you.  I will go through the questions and points you raise in order.

What looks like movement of the indentations is more likely the result of changes in the internal scar tissue, causing different patterns of pull on the tunica albuginea and layers of fascia within the shaft.  There is a wide variation of development of Peyronies, so be aware that your particular situation might be different from others you read about.  for many men these small but accumulative changes of the PD plaque or scar causes deformity changes over a period of many years.

There are two probable ways you could be experiencing ED at this point:  Physical – from the growth or contraction the PD scar material causing the internal valves of the veins of the shaft to remain open, thus preventing development of internal hydraulic pressure that creates an erection.  Sometimes this is a widespread problem affecting the entire shaft, and sometimes a local problem causing dents or bottleneck deformities.  Emotional – you are, as most men feel, angry, confused, scared, and/or embarrassed about what is happening to you.  The emotions have a great impact on the development of the erect state.

Using vitamin E by itself is almost no treatment   Vitamin E as a Peyronie's treatment is a great therapy, very essential, but it must be combined with other therapies to get the right kind of tissue response you are looking for.  

Treatment is the most thoroughly discussed subject on this website.  See "Introduction to Alternative Medicine treatment of Peyronie's Disease," and "Guide for Peyronie's Disease Treatment," and many others.

The PDE-5 category of drugs (Viagra, Levitra, and Cialis) can cause problems due to excessive erection development, resulting in over-inflation and possible tearing of internal tissues of the shaft.   See "Peyronie's Disease Plaque, Viagra, Cialis, Levitra and Blood Supply"  and  "Peyronie's Disease Treatment and Viagra, Levitra and Cialis" and many others.

Far better to learn about Alternative Medicine treatment of Peyronie's disease, take control of your situation, stop feeling so helpless and reduce your stressful state.  If you have specific questions about treatment please let me know.     TRH   

What is my opinion of prescription drug injection?

What is the Dr's opinion on using the prescription Edex injected with a syringe? 

Bryant from Ohio

 

Greetings Bryant, 

You ask for my opinion about Edex injections.  I will not comment on the drug, because that is the decision of your treating doctor.  But I will make a few observations about injections in general and how they could further injure the tunica albuginea.

Anytime you inject ANYTHING – even sterile water – into the penis and directly or indirectly contact the delicate tunica albuginea, you are taking a serious risk of making your Peyronie's disease worse. This could either occur just from the simple act of piercing the tissue of the tunica albuginea, or the placement of a concentrated chemical that is foreign to that tissue, or both.

I have communicated with many, many men whose Peyronie's disease started or was made worse from penile injections of a variety of substances.

If your problem is PD, why are you taking an ED medication? Some MDs prescribe Viagra, Edex, etc to their PD patients in the belief that this increases the local circulation which in turn is beneficial to PD.

What if you could take a drug that would enable you to lift a ton of weight above your head and keep it there for an hour? Nice trick, very impressive, but your body is not built to take that kind of pressure. It would cause great damage to internal organs, your spine, your blood vessels, all major joints, etc. Simply put, “It just ain’t natural.” Same with Viagra, Levitra or Cialis. The increased pressure created by these medications can be very damaging to the delicate tunica albuginea, and can result in or worsen a case of PD. What would happen to your car tires if you happened to over-inflate them with 100 pounds of air pressure, even though they were built to take just 40 pounds of pressure. You would be running the risk of damage to the internal structure of tire, wouldn’t you? Of course.

The same thing can happen if the penis is over-inflated and then given a “rough ride.” This is where the problems start, and this is what I wanted to bring to your attention. It is very likely that the MDs who prescribe these medications to men with PD will not agree with this thinking. MDs tend to favor a chemical “fix” even if it is temporary, so you would tend to expect a prejudice from an MD to use drugs to solve most problems.

A penis that is predisposed to PD in the first place cannot tolerate the kind of stress that these erections drugs create.  If you think independently and logically about what happens when these drugs are used, you should have no trouble understanding how this could work against you.  That is just the way I see it and I feel compelled to share this rationale with you. Use of Viagra and other related meds like it could easily be worsening the very problem you are attempting to heal. Something to think about.  TRH

Pentoxifylline and Peyronie’s Disease Treatment

Pentox for Peyronie’s treatment is an off-label use

Every now and then I get an email asking for my opinion about using Pentox (Pentoxifylline) for Peyronie’s disease treatment.  Over time I have developed a few ideas about this controversial drug that is gaining some popularity as an off-label Peyronie’s treatment.

Those MDs who prescribe Pentox are still trying to figure out the best way to use it, not only for PD but for many other conditions.  While the primary use for Pentoxifylline is based on its ability to increase peripheral blood circulation, hence it is used to treat senile dementia and intermittent claudication, Pentox is gaining acceptance with the medical community for Peyronie’s treatment.

Some MDs who have learned the hard way that PDE5 drugs (Viagra, Cialis, Levitra) are not at all a safe or effective Peyronie’s treatment have instead begun to prescribe Pentox to increase blood flow in Peyronies.   But to have that make any sense at all you have to believe that PD is caused by reduced blood flow in the first place, or that merely increasing the blood flow will somehow help PD.  I can totally agree with that thinking if you have evidence that your penis suffers from reduced blood flow (it is cold and blue).  But if your penis is not cold and blue and bent, then you probably will not benefit from Pentox in the way that most people think.

It is my opinion that when Pentox is said to help men with PD it is because as the blood flow is increased to the periphery, it also brings in an increased flow of nutrients to assist the healing process.  Further, when Pentox helps a case of PD it is because of the totally secondary benefit of increasing the body’s ability to heal and repair the PD plaque when there are more nutrients in an area of the body.   It is a small point, perhaps, but a vitally important point to understand that it all comes down to the body healing the PD scar – not the Pentox having some curative ability by itself.   If Pentoxifylline can increase general circulation more safely than Viagra, Cialis, and Levitra, then great I am all for that.  But you have to consider that if you do not have a circulatory problem in the first place, then why take any of these drugs at all?

If the benefit of Pentox is to bring more nutrients into the tissues, to assist healing and repair of the PD plaque or scar, that is wonderful.  If it is beneficial to bring more nutrients into the tissue, would it not be a more logical and effective Peyronie’s treatment to intentionally and intelligently supply a wide variety of nutrients at a higher than average dosage to the body to assist the healing process?  After all, that is what PDI has been doing since 2002 and it works in a great percentage of cases when it is done correctly.

Since extremely few men actually have any evidence of a circulatory problem in the pelvis, taking Pentox or even Viagra, Cialis, and Levitra, will not make a difference because that is not the problem that is going on with PD.   If the problem is that you did not heal your tunica albuginea injury because of poor nutrient availability then I suggest it would do you a lot of good to increase the nutrients directly, not indirectly by playing with the circulatory system when there is no circulatory problem.

You notice that I do not say, “Do not take Pentox,” I only say it is new so use caution.  I also say that when Pentoxifylline helps it probably does so only because it helps the body work better by increasing available nutrients, not because it specifically increases blood flow.  If you want to help your pelvic blood flow:

1.    Wear boxer shorts

2.    Uncross your legs when you sit

3.    Do some Kegel exercises

4.    Put a moist hot pack on your privates when you watch TV

Most MDs are taking the attitude that while they do not know if Pentox helps PD, or why it helps when it appears to help PD, at least they currently have no evidence that it makes PD worse – so what the hell, take it and let’s see what it does for you.  This is how many medical patients get hurt in the long run with such a cavalier attitude about drugs.

I say better to take an Alternative Medicine approach to your problem to help your body heal and repair the Peyronie’s pathology naturally.