Is there a place for conservative treatment in Peyronie's disease?
BACKGROUND
Peyronie's disease (PD) is a relatively common disorder affecting middle aged men. Conservative nonsurgical treatments include oral, topical, and intra-lesional pharmacotherapies, vacuum stretching, and mechanical traction.


METHODS
Four people with expertise and/or interest in the area of PD were asked to contribute their opinions with regard to the safety and efficacy of nonsurgical conservative treatments.


METHODS
To provide food for thought, discussion, and possible further research in a poorly discussed area of sexual medicine.


RESULTS
Of the four experts writing on the topic, one believes a combination of medical therapy and penile traction has positive potential for curvature. Another feels that although medical therapies have potential to alleviate pain, there is little evidence to show that they help with curvature or that penile traction helps. A third expert proposes dividing the disease into phases, where patients in the acute phase may benefit from conservative therapy, whereas patients whose disease is stable require surgical intervention. The last expert agrees that the therapy should depend on the stage of the disease, but believes like the first expert that there is a role for traction therapy for patients with stable disease.


CONCLUSIONS
There is a need for guidelines for nonsurgical therapies for patients with PD, but there is a paucity of evidence as to their efficacy.
Vardi
Yoram
Y
Rambam Medical Center & Technion Faculty of Medicine, Haifa Israel.
Levine
Laurence A
LA
Department of Urology, Rush University Medical Center, Chicago, IL, USA.
Chen
Juza
J
Tel Aviv Sourasky Medical Center-Urology, Tel-Aviv, Israel.
Hatzimouratidis
Konstantinos
K
2nd Department of Urology, "Papageorgiou" General Hospital and Center for Sexual and Reproductive Health, Aristotle University of Thessaloniki, Greece.
Sohn
Michael
M
Department of Urology, Markus-Hospital, Frankfurt, Germany.