My doctor wants to put cortisone injections into my Peyronies scar, what do you think of that?
Will steroid injections reduce the inflammation and pain of my Peyronies?
My opinion is that it is risky to use cortisone injections as a Peyronie's treatment. While a temporary and variable reduction of pain does occur in some cases, but not all, it is not worth the limited benefit that makes future Peyronies surgery more complicated and dangerous should it become necessary. There is good reason to think twice about using steroid injections for this purpose. This website has presented an earlier article about a closely related topic, Peyronie's disease treatment via direct drug injection.
It would be good to talk to your doctor about other treatment options or to consider using Alternative Medicine as a way to increase your natural ability to eliminate the Peyronies scar. The PDI website explains how this can be done without the use of drugs and surgery.
In the 1960’s steroid (cortisone) injections were used as a Peyronie’s treatment under the theory that they would reduce plaque or scar formation because of the inhibitory effect cortisone has on fibroblast cell formation. Since fibroblasts are cells that make fibrin, and fibrin makes collagen in the body, with fewer fibrin cells the ideas was that this would result in less collagen produced during scar formation.
This treatment for Peyronie’s was used rather extensively until the mid-1980s when it became obvious that it did not consistently or greatly reduce collagen at the Peyronie’s plaque. And of equal concern was the observation that these steroid injections were causing penis tissue weakness (atrophy) of blood vessels, nerves, and all connective tissue of the corpora cavernosa and tunica albuginea of the at the site of the injections near the Peyronie’s plaque. These steroid injections resulted in weak and fragile tissue that would easily tear when a surgeon would try to sew it together during surgery, or worse yet would tear after surgery or heal slowly or not at all.
It took a long time to notice and correlate this problem because virtually all of the studies of using cortisone injections in Peyronie’s disease did not use a placebo control, and they performed with only a small number of patients who reported their improvement subjectively without objective measurement of progress in terms of pain, plaque formation and deformity reduction.
Seldom did the steroid injections actually have a beneficial effect on the eventual Peyronie’s disease outcome, but had an undesirable side effect that made Peyronie’s surgery complicated and less effective. The problem was that the broad tissue destruction caused by the cortisone made the tissue so weak and compromised that a surgeon could not later go into that same area to suture the tissue closed at the site of a surgical incision, or expect the sutures to hold on the weakened tissue. If penis surgery was done it often resulted in frequent bleeding and repeated opening of surgical wounds. Once it was seen that cortisone injections made it difficult to do good surgery later, the practice began to fall out of general use.
In addition, the practice of using cortisone injections for treatment of Peyronie’s disease did not take into account the harmful effect of placing a series of multiple needle punctures into the scar material and the tunica albuginea tissue of the penis. Later clinical observations have shown that these frequent and repeated needle punctures act as additional trauma to tissue that has already shown itself capable of producing excess scar formation to repeated small injury. This has also proven to be the case when a series of multiple injections of other drugs like verapamil and interferon are used as Peyronie’s treatment. The clinical results of these other drug injections have not provided positive or encouraging clinical results that were any better than those of cortisone injections.