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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Peyronie’s Disease Treatment with ESWT

Breaking up gravel and Peyronie's disease

Peyronie’s disease treatment has been done in recent past times with ESWT, although after just a few years of promotion and use it has rapidly fallen out of favor.

ESWT or Extracorporeal Shock Wave Therapy is a standard medical procedure that involves the use of shockwave lithotripsy (high pressure and low frequency sound wave) technology to treat Peyronie's disease.  The machine that actually creates the extracorporeal shockwaves is a device located outside the body, that is applied over the affected tissue of the Peyronies plaque. In Peyronie's disease, the fibrous plaque or scar is the target of these shockwaves that are identified with an ultrasound scanner.  The ESWT shockwaves per session range from 2000-3000, applied over several minutes, with the average patient receiving 4-6 treatments and a maximum number of sessions of 12. This procedure can be performed with or without sedation, although most men prefer sedation after their first actual encounter with ESWT.

Although ESWT is primarily used as a treatment for kidney stones, this shock wave therapy or lithotripsy, has also been attempted for Peyronie's treatment since the early 1990s. However, more recent studies re-evaluating the effectiveness of ESWT for Peyronie's disease have only shown mixed results. Some studies have found ESWT restores normal erections and reduces pain associated with Peyronie's disease.  However, additional studies could not reproduce those same findings, and have not found any clinical benefit. Further research is needed to fully evaluate what role, if any, shock wave therapy should play as a treatment for Peyronie's disease.

The current evidence concerning the safety of ESWT for Peyronie’s disease appears adequate, using accepted medical standards.  However, keep in mind that accepted medical standards also suggests that Peyronies surgery that leaves many men impotent or totally numb or more distorted after the surgery is also thought to be safe.  Even so, the evidence for the effectiveness of ESWT does not appear adequate to support the continued use of this procedure without special arrangements and for audit or research; this means that if you want to use ESWT, you will have to agree to use it on a research basis because it has not proven to be effective.  Doctors who use ESWT must therefore tell their patients that the outcomes of this procedure are uncertain and there is unclear effectiveness in relation to the risks involved.

ESWT safety

 

Safety is always an issue in any healthcare matter.  In the several studies of ESWT safety that have been conducted since the late 1990s, according to medical review, “relatively few complications were reported. Complications were mostly of a transient nature and included urethral bleeding, bruising, skin discoloration due to petechiae (small dot-sized bruises), and hematoma (large bruises). The relationship between the energy level used in the treatment and the reported complications is unclear…The Specialist Advisors did not note any particular safety concerns about this procedure. Superficial bruising and moderate local pain were noted as potential adverse events.”

This disconnected thinking seems to be typical of many medical reviews of Peyronie’s disease treatment options.  On one hand, the report of ESWT safety casually mentions urethral bleeding, along with large and small bruising of the penile tissue. On the other hand, it does not consider that small trauma is often sufficient to trigger the onset of Peyronie’s disease.  Perhaps a trauma large enough to cause bleeding and bruise marks is no big deal to a medical researcher, but ask a man whose PD started from a small and one-time injury during sexual relations.

Think of what a jack-hammer does to concrete

It seems unbelievable that medical researchers, who the public rely upon for approval or disapproval of Peyronie’s disease treatment options, can be this ignorant of the situation concerning Peyronie’s disease.  Perhaps this entire body of researchers did not consider that a trauma large enough to cause penile bleeding and bruising might just be sufficient to cause or aggravate Peyronie’s disease.

In fact, no medial explanation has been offered how beating on a Peyronie’s disease  plaque 2000-3000 times with a high pressure and low frequency sound wave is going to help the problem.  Recall that this technology was intended to break up kidney stones.  A Peyronies plaque is not a kidney stone.  The fact that the scar or plaque is sometimes calcified in latter stages is perhaps where the connection started between kidney stone and Peyronie’s disease.  Yet, it must be considered that the tunica albuginea of a man susceptible to Peyronie’s disease is unlike other tissue.  When irritated it develops plaque material, especially when subjected to something as strong as 2000-3000 sound waves strong enough to break up a kidney stone.

It just never made sense to me when I first heard of the ESWT concept several years back, and I was the only one saying that kind of direct and repeated trauma capable to break kidney stones could not be beneficial to the tunica of a man who already has Peyronie’s disease.  Over time I heard less and less of ESWT and how even the Canadian clinic that promoted it so heavily has stopped doing the procedure.

It seems that common sense is not that common, especially when it comes to Peyronie’s disease treatment.