Standard Peyronie’s Disease Treatment as Practiced Today
Listen To Your Doctor
PDI wants all Peyronie’s disease (PD) patients to follow the sound advice of his personal medical doctor or surgeon. We suggest only that a man takes the ideas and suggestions for alternative and complimentary care offered in this website to that physician for discussion and evaluation. PDI strongly recommends that a man with PD listens very closely to the answers from his doctor, and acts accordingly.
Pipeline of Peyronies information
Considerable space is used on medical websites to explain standard and customary treatment of PD. From these we learn there are two methods of medical treatment: drug and non-drug (surgical). In these discussions even naturally occurring vitamins and enzymes are often included as drug treatments, as though any treatment suggested by the medical profession must be drug related. This underscores that medical care in this country is heavily influenced by, dependent on, and slanted toward pharmacological therapy. The influence of the pharmacology industry extends so deeply into American medical practice that the drug companies determine what potential drugs will be researched, tested and approved for treatment of a disease – including Peyronie’s disease.
No drug is used in medical care that has not come through the drug industry pipeline, and the drug industry controls the medical pipeline. The drug industry is not interested in putting vitamin C, serrapeptase, or other simple treatments into the pipeline because there is insufficient interest, based on insufficient profit compared to the effort and expense of proving their effectiveness. Only potentially profitable things get into the pipeline. Vitamins, enzymes and commonly available substances stay out of the pipeline and continue to be given the terrible sounding label of being “unproven”. In this way, “unproven” can mean that many of these basic treatments are simply being ignored by the drug industry, and does not necessarily mean they are ineffective.
Go to our special FAQ page for answers to frequently asked questions about the PDI concept for natural and holistic Peyronie’s treatment.
Concerning drug treatment of PD, the websites all report the same thing one way or another. Here is a discussion about PD treatment from the American Academy of Family Physicians. This is a favorite example because none do it so well with one grand denial and warning about every treatment available, except Peyronie’s disease surgery, of course:
“Oral agents, particularly those with antioxidant properties, have been tried with limited success. Such agents include vitamin E, potassium aminobenzoate (Potaba), and colchicine. Experimental intralesional treatments include corticosteroids, parathyroid hormone, collagenase and verapamil (Calan). Various modes of energy transfer, including ultrasound, radiation, laser therapy, short-wave diathermy and lithotripsy, have also been used. However, all current published reports of these treatments have been compromised by limited-sample patient populations, lack of control populations, poorly characterized outcome parameters, inadequate follow-up periods and inconclusive results. It has been difficult, therefore, to determine which, if any, of the nonsurgical treatments may be effective. Caution should be used when recommending any of these experimental treatments.”
From the National Institute of Health we learn, “Some researchers have given vitamin E orally to men with PD in small-scale studies and have reported improvements. Yet, no controlled studies have established the effectiveness of vitamin E therapy. Similar inconclusive success has been attributed to oral application of para-aminobenzoate, a substance belonging to the family of B-complex molecules.”(1) So, this powerful government agency knows of, or at least suspects, improvement of PD is possible with vitamin E and para-aminobenzoate. But these findings are not “proven” in a way necessary for the NIH to officially recommend it. Then why doesn’t someone just correctly and completely test vitamin E and para-aminobenzoate, and prove one way or the other if they are useful in treating PD? Sounds simple; all it takes is an interest in finding out the truth and the money to get it done – mostly money. Without this recommendation from the NIH and other regulating bodies, neither vitamin E nor para-aminobenzoate will be recommended or used by doctors with much enthusiasm.
As you go over the medical websites, have you wondered why so many things are reported to be “unproven” for use in treatment of PD? They admit that the common and readily available things reported to be “unproven” are successful “sometimes”, “in some cases”, “in a small research paper”, “only 60% of the time”, in treating PD: vitamin E, some basic enzymes and amino acids, an herb or two, a few drugs, even a by-product from wood pulp processing. There is little interest in these substances since they are used in other applications, and do not have much profit potential. Profit potential? What does profit potential have to do with scientific research and medical use? Hmm. Apparently for reasons of profit, these simple treatment measures are not put in the drug pipeline for full review, and thus they remain unproven. Since they are unproven, they receive no support from the scientific community. Without scientific approval they are not used by the medical community in treatment; thus, they remain controversial and “unproven” for a reason. For more on this, click A Honey of an Idea.
Peyronie’s disease and surgery as an option
Surgery is presented in the medical websites as the only sure and proven treatment option for PD. While drug options have variable success, surgical repair is currently regarded as the best way to remove the Peyronie’s scar.
Surgery is presented as the back-up choice to be used if PD leads to extreme pain, distortion and impotency. The American Academy of Family Physicians states, “Despite numerous treatment options, there is no generally accepted, standard non-surgical treatment for Peyronie’s disease.” With this statement they are confirming that there is one accepted treatment for PD – and it is surgical.
The person who reads this information is comforted by knowing that in the face of this terrible problem at least there is a surgical treatment to rely upon if all else fails. Surgery is presented almost as though if you gambled and lost with the wait-and-see option or with medication, you can always rely on good ol’ surgery to correct your problem.
In our opinion, while it is fundamentally true that surgery might be presently the one best standard way to treat an extreme case of PD, we believe that the cautious and informed reader needs more information about surgery than is clearly presented in the average medical website. Our opinion is not that surgery is bad; no, we agree that surgery is a realistic option, and maybe the only option for many men with PD. Our caution is that there is not sufficient information given in these websites discussing surgical failure upon which a man can base an informed decision.
As one example, there is a long and detailed discussion about PD from the Department of Urology, University of California School of Medicine, San Francisco. In that discussion there is just this one very brief sentence concerning the outcome of surgery, “Literature review shows excellent results provided men have realistic expectations.”(2-5) Read that quote again. Your eye first picks up, “excellent results”, and you almost pass over the last part, “provided men have realistic expectations”. So, Peyronie’s surgery works out very well so long as you don’t expect too much. Think about it.
Here are a few questions to ponder a while: What does that quote about surgical results from the University of California School of Medicine mean, “…excellent results provided men have realistic expectations”? If medical websites offer surgery as the best option for PD, but very little is written about surgical results and there are no glowing reports of surgical outcomes, what does that mean? If the average man with PD develops a large scar on his penis from of an injury so small that often it cannot be remembered, what kind of scar formation might occur from an actual surgical cut to remove the first PD scar? These questions are posed not to suggest that a man with PD should not undergo surgery; they are offered to put into perspective the need and importance of first taking care of the penile scar with safe conservative measures, so that surgery might possibly be avoided. It could be a mistake for someone with PD to have a casual and unrealistic attitude about surgical correction of the PD scar. No surgery should ever be taken lightly or for granted, let alone a man who is thinking about getting cut in an area that has already demonstrated an excess tendency for scar formation.
Insufficient details are provided on the internet describing the end result of PD surgery. It is all too common for an entire two or three page article to say nothing about actual outcomes of penile surgery or just one sentence, as in this Mayo Clinic commentary: “Surgery is generally effective at restoring normal erections, although each method can cause unwelcome side effects such as partial loss of erection or shortening of an erect penis.” Read that sentence again: it says that PD surgery is generally effective in fixing loss of erections except when it causes a loss of erection, or a loss of penis size. Our opinion is that information like this is not helpful or informative to a degree necessary to create a realistic image of what happens as a result of penile surgery. If all of the information upon which a man bases his decision for PD surgery is a clear and helpful as this information, then he is insufficiently informed.
Perhaps the National Institute of Health is more candid than most websites by simply explaining, “Peyronie’s disease has been treated surgically with some success.”(1) Perhaps if a man knew that surgery results in “some success” he might not think surgery was an easy answer to his problem, and he would think twice about doing nothing for his ailing penis. Perhaps if a man knew exactly what “some success” meant, he would know how to evaluate his options. But that is never explained.
Understand why Alternative Medicine treatment of Peyronie’s disease is not accepted by traditional medical practice, click Science is Slow.
Explaining surgical methods of repair and removal of penile scar tissue, the NIH mentions, “The second method, known as the Nesbit procedure, causes a shortening of the erect penis.”(1) This article does not mention that the loss is one to two inches of penis length. This same article reports, “Most types of surgery produce positive results. But because complications can occur, and because many of the phenomena associated with Peyronie’s disease (for example, shortening of the penis) are not corrected by surgery, most doctors prefer to perform surgery only on the small number of men with curvature so severe that it prevents sexual intercourse.” In another commentary the NIH states, “Surgical correction may also lead to impotence.”(6) Such a limited explanation – no percentages, rates or comparisons – does not assist in making an informed decision. With such a partial picture of what happens after surgery, a man is kept from understanding what really happens after penile surgery. Perhaps the man with PD should ponder why that information is not offered.
Many of the website discussions about surgical outcomes contain partial answers and twisted information. A man reading these discussions could assume surgery was a better and easier answer than it actually is. He could believe that the best treatment choice early in his PD was to do nothing – wait-and-see what happens – because he could always see the surgeon and get fixed up as good as new. Careful reading shows this is not the case.
Since our caution to the reader suggests that surgery is not without its own considerable risks, our opinion is that it is wise and prudent to do all that you can to avoid being put in a position where surgery is your only option.
Standard medical care today
Many doctors suggest doing no treatment in the early stage of PD, for two reasons. First, there is no drug treatment that is proven successful in helping PD. Second, since 5-50% of the cases get well on their own with no treatment, they prefer a wait-and-see approach to see if the PD gets bad enough to require surgery. Many doctors appear to be content – even satisfied with the wait-and-see approach – when their patient develops only a slight bend in the penis or develops only a moderate impotency problem. From the medical discussions in many websites, these slightly disabling outcomes are considered to be an acceptable medical outcome. Read the medical website reports and discussions to understand where the medical thinking is coming from. The attitude that is so prevalent is this: PD is only a serious problem if it is bad enough to require surgery; if it doesn’t need surgery, it’s just an inconvenience. With that attitude, it is no wonder not much progress has made in finding a cure for PD, or that there is not more effort made to extend help to a man with this problem.
PDI does not consider peeing on your foot the rest of your life because your penis is bent like a cane as a satisfactory outcome or an inconvenience; it’s a tragedy. Even if there is no perfect answer, and only spotty research to support a cure, PDI’s opinion is to use the best of what is available while the jury is out looking for the truth about PD. If what you do makes a difference in your health, look what you have gained; if it does not help, at least you did your best, and you cannot feel bad about trying. For more discussion along this line, please click on Peyronie’s Treatment and Russian Roulette.
So, what do you do if you have Peyronie’s disease?
Learn how easy it is to create an effective Alternative Medicine plan, click on Organize Peyronie’s Disease Treatment.
All of the above is not presented to say Peyronie’s disease surgery is bad, or to scare men away from it.
The intent is to put things into perspective. It is the opinion of the doctors of PDI that to play a “wait-and-see game” while there are many viable and potentially beneficial ways to assist your tissue repair, just because surgery is an option, sounds ludicrous. It seems as though most websites whitewash the whole surgery option, downplaying what really happens post-surgically. Because there are no easy answers to PD – especially surgical – PDI encourages any man with PD to do all he can to make the surgical option unnecessary.
The current situation leaves the man with Peyronie’s disease with only a few options:
1. Wait on the sidelines while the drug companies research, discover and patent a wonder drug.
2. Wait on the sidelines while the scientists figure out how to conduct a valid study to verify the substances they think might be helpful, but currently are “unproven”. Isn’t it strange they can perform these studies very well when a new wonder drug is involved, but can’t do the tests correctly for vitamin E?
3. Wait on the sidelines until you need surgery, then hope for the best.
4. Use several of the many safe and researched vitamins, enzymes, herbs, and other substances that receive reports of variable success for PD from around the world for PD, or for problems similar to PD. Take advantage of the power of synergy to do all that you can to increase your healing capacity to correct your PD.
The latter choice, using a few of the alternative methods of complimentary medicine that are not mainstream, is really not such a strange gamble as some may think. Go to our section, PDI Treatment Plan, to read about the many alternative and complementary natural Peyronie’s disease treatment methods suggested by the doctors of PDI. You might find a few things to consider doing for yourself that will make sense to you and will empower you.
Learn how easy it is to create an effective Alternative Medicine plan, click on Organize Peyronie’s Disease Treatment.
1. NIH Publication No. 04-3902 – December 20032. Carson CC: Penile prosthesis implantation in the treatment of Peyronie’s disease. Int J Impot Res, 10: 125-128, 1998.3. Pryor J: The Management of Peyronie’s Disease. In: Porst H (ed.). Penile Disorders. Berlin, Springer-Verlang, pp. 35-56, 1997.4. Eigner EB, Kabalin JN, Kessler R: Penile implants in the treatment of Peyronie’s disease. J Urol, 145: 69-71, 1991.5. Montague DK, Angermeier KW, Lakin MM, Ingleright BJ: AMS 3-piece inflatable penile prosthesis implantation in men with Peyronie’s disease: comparison of CX and Ultrex cylinders. J Urol, 156: 1633-1635, 1996.6. U.S. National Library of Medicine, National Institute of Health Updated by: Young Kang, M.D., Department of Urology, Columbia University College of Physicians and Surgeons, New York, NY. – 5-25-02