Management Strategies for Peyronie's Disease

The management of Peyronie’s disease encompasses a spectrum of interventions tailored to the phase and severity of disease. Conservative strategies in the acute phase focus on symptom control and plaque modulation using oral agents, intralesional therapies, mechanical traction and extracorporeal shockwave therapy. Oral medications—such as pentoxifylline and antioxidants—aim to attenuate oxidative stress and fibrotic signalling, while intralesional injections (collagenase, verapamil) reduce plaque size and curvature. Mechanical traction devices may remodel fibrotic tissue and preserve penile length. Surgical correction becomes appropriate in stable, chronic disease with pronounced curvature or functional impairment; techniques include tunical plication, plaque incision or excision with grafting and penile prosthesis implantation. Emerging approaches target cellular pathways, for example modulation of phosphodiesterases and cytokine networks. A holistic approach integrates psychosocial support and patient counselling to address pain, deformity, sexual dysfunction and emotional distress. Individualised decision making requires assessment of plaque characteristics, erectile function and patient expectations to optimise outcomes.

Research from Nature Portfolio

Recent cohort analysis has highlighted the psychosocial burden of Peyronie’s disease, demonstrating a significant increase in relationship separation among affected men. The study found a 13 per cent rise in the risk of separation and an 18 per cent increase in annual separation events compared with matched controls. These findings underscore the importance of incorporating psychological and relational support within comprehensive management plans to mitigate the wider social impact of the disease.

Management Strategies for Peyronie's Disease publication trend

The graph below shows the total number of articles in management strategies for peyronie's disease across all publications each year (not limited to Nature Index journals).

Technical terms

Tunica albuginea: A fibrous envelope of the corpora cavernosa that becomes the site of plaque deposition in Peyronie’s disease.

Myofibroblast: A contractile cell type that contributes to fibrous plaque development by secreting extracellular matrix proteins.

Phosphodiesterase (PDE): Enzymes that degrade cyclic nucleotides (cAMP, cGMP) and regulate intracellular signalling pathways.

cAMP (cyclic adenosine monophosphate): A second messenger involved in cellular responses, whose elevation can inhibit fibrotic transformation.

Intralesional injection: Direct administration of therapeutic agents into the fibrous plaque to reduce fibrosis and curvature.

References

1. Oxidative Mechanism of Peyronie’s Disease and Effectiveness of Pentoxifylline in the Therapeutic Management: A Narrative Review. Antioxidants (2025).
2. Inhibition of phosphodiesterases 1 and 4 prevents myofibroblast transformation in Peyronie's disease. BJU International (2024).
3. Risk of relationship separation in men with Peyronie’s disease in a matched Swedish cohort. Scientific Reports (2024).
4. Non-invasive treatment in the management of Peyronie’s disease. Therapeutic Advances in Urology (2019).