The conservative treatment of peyronie's disease is possible in cases of acute phases and in the initial phases. With the help of pills and injections, it is possible to remove the pain, stop the inflammatory processes. Get rid of the external signs of the curvature of the penis, is possible only through the injection into the plaque or surgically.
At the first signs of the curvature of the penis, you should consult a specialist. The doctor andrologist pick up for you the optimal solution of the problem. After diagnosing a possible target of conservative therapy.
How to cure peyronie's disease without surgery: principles of therapy
The principles and objectives of conservative treatment of peyronie's disease are:
- extraction of an acute inflammatory process, reduction of its surface and the intensity in the tunica shell of the penis;
- the reduction of the pain syndrome;
- the prevention of the formation of the platelet;
- reduction of the surface or of the complete dissolution of the platelet;
- it may be necessary to perform conservative treatment of peyronie's in the post-operative period .
It is possible the application of physiotherapy procedures, oral drugs, local therapy, the injection of the methodology. Cure peyronie's disease in the early stages can help only therapy, which will include several approaches.
Drugs for the treatment of peyronie's disease
There are a number of drugs that underwent clinical trials and effective for peyronie's disease. Each of them has its effect, directed to the different links of the pathogenesis of the infection, which requires their integrated application.
Only when face-to-face examination, ultrasound and doppler penis, the doctor can suggest what type of treatment can be effective (much depends on the causes of the disease).
The treatment of peyronie's disease without the operation of paraaminobenzoic
This medication has a number of useful therapeutic effects:
- inhibits the proliferation of fibroblasts;
- reduces the secretion of mucopolysaccharides, and glycosaminoglycans;
- increases the absorption of oxygen by the tissues of the penis;
- press fibrinogenez.
Sample for the treatment of adult men with peyronie's disease with the outfits the plate and the deformation of the curvature of not less than 30 degrees at the beginning of the therapy. You enter directly in the plate. Each injection helps to weaken and destroy the plaque and help straighten the penile curvature caused by peyronie's disease.
The vitamin E in the peyronie's disease
Vitamin E, an antioxidant fat-soluble, inactivates the free radicals, which saturate the nitric oxide (NO), thereby contributing to increased levels of active and does NOT guarantee the proper healing of wounds. To limit oxidative stress, are also potentially anti-inflammatory effect. For the first time has been described for the treatment of peyronie's disease in 1948 and,thanks to its low cost and availability, continues to be the most often designated by an oral tool for the treatment of ic. Despite their use during the past seven decades, multiple placebo-controlled studies have not been shown to significantly improve the pain, the degree of curvature, the size of the plates or of the recovery of the erection. In 1983, Pryor and farrell completed, double-blind and placebo-controlled trial of vitamin E in 40 patients with bp and not found to significantly improve the size of the platelets or of the curvature of the penis. In addition, most of a recent study conducted in the year 2007, has provided the largest to date for the evaluation of vitamin E for the treatment of peyronie's disease. The authors compared vitamin E alone and in combination with L-carnitine with placebo, 236 of the men with the chronic of the charter of rights; it is classified as a patient with pain during erection, curvature of the penis has no influence on the vaginal penetration, pain palpabile scar, hyperechogenic damage in the ultrasound examination of the penis, the lack of calcification, and the total surface area of the platelet <2 cm2.
Group 1 (58 men) received 300 mg vitamin E orally twice a day.
Group 2 (59 men) received propionyl-L-carnitine 1 g by mouth two times a day.
Group 3 (60 men) received 300 mg vitamin E orally twice daily or 1 g propionyl-L-carnitine orally twice a day.
Group 4 received a similar scheme to receive placebo for 6 months during trial period. After the therapy is not a significant change in the reduction of the curvature of the penis between the four groups (P = 0.9), as well as in the size reduction of the platelets (P = 0.1) (12).
Despite the lack of evidence to support the effectiveness of vitamin E, it is still often prescribed assigned at the same time with other methods of treatment, with the hope of synergistic role. The common side effects of using vitamin E include nausea, vomiting, diarrhea, and increased risk of developing prostate cancer.
Heparin ointment in peyronie's disease
Heparin ointment reduces the inflammatory process in the tissues of the penis, stretches the vessels, optimizing hemodinmica.
Can be designated for the treatment of pain in acute phases. Therapeutic effect of ointments are not.
Omega-3 fatty acids
The omega 3 is held the test of peyronie's disease (due to the anti-inflammatory properties)
In 2009 published the results of an investigation in randomized double-blind study of omega-3 fatty acids in comparison with the placebo.
A total of 224 of the patient from the beginning of the chronic stage of the bill of rights were randomly assigned to the dose of 1.84 g daily supplements of omega-3 in comparison with the placebo for 6 months.
Unfortunately, there have been significant improvements in terms of the volume of the platelets, the curvature of the penis, pain during erection and erectile function. Currently, there are no data that confirm the positive effect of the intake of omega-3 fatty acids in the beginning of the chronic phase of peyronie's disease.
Omega-3 are useful for any person. You can take omega 3 without prescription. But no therapeutic effect is not.
The inhibitors of the phosphodiesterase type-5 inhibitors (pde-5)
Although inhibitors of pde-5 in general, are considered as treatment of erectile dysfunction (ED), recent studies have shown its potential application in the treatment of peyronie's disease in patients with or without ERECTILE dysfunction. The pde5 inhibitors increase cyclic guanosine-monophosphate (cgmp), inhibition of the degradation of GMP to GMP. With the increased levels of cgmp and NOT the synthesis and deposit of collagen is stopped, and causes the apoptosis of the fibroblasts and monitoring and evaluation-of the fibroblasts.
Thanks to this property, the inhibitors of PDE-5 which can be useful for the remodeling of the scar.
At this time there was only one study, that seemed to be the improvement of the rubtsovih the entities in the penis. But all of the patients were without tangible platelets. And the deformation is not more than 10%.
At this time pde 5 is not assigned. It may be later, when they appear again in clinical trials and has been proven the effect of the treatment.
L-arginine contributes to the reduction of the fibroblasts due to apoptosis. The mechanisms underlying the L-arginine allow to consider it as an anti-fibrous agent.
Researchers have evaluated the plaque of the penis in rats treated with inhibitors of pde-5 and l-arginine. As inhibitors of PDE-5, L-arginine has shown a significant reduction in the size of the platelets, as well as the relationship of collagen to the fibroblast. Subsequently, the study has shown that arginine also has a protective effect against the education of scar tissue when exposed in the penis of rats.
In the year 2012 observed a tendency to the improvement of the curvature in patients with ic treated with the penis in combination with vnutricletocnam verapamil, oral L-arginine and oral pentoxifylline (PTX). Although this study has a multitude of variables that can contribute to the improvement of the curvature, it turned out to be one of the few tests in humans, in which the L-arginine has been used for the treatment of ic. Taking into account these results, L-arginine may be a useful treatment option in the bill of rights, but more evidence is needed in humans.
L-arginine can be assigned in the comprehensive plan of conservative therapy.
Peyronie's disease without surgery: local introduction of drugs
This method is most effective in the correction of the curvature of the penis, which the use via the media. Injectable medications, local anesthetic is injected. The procedure must be carried out exclusively by an experienced technician.
Medications are introduced in tunica the sheath of the penis (directly on the plate and the scar). The execution of a procedure should be performed with the utmost care, as there is a great risk to get worse during the pathological process, increase inflammation, the number and volume of platelets.
The possibility of treatment of the injection depends on the size of the plate, their location and the condition of the patient. If the injection is a long process, on-line, the treatment of the curvature can release a single operation. In the in-person consultation to determine the best treatment option for each patient.