Nonsurgical management of Peyronie's disease

Peyronie's disease is not a rare disorder, and it can be devastating to the affected man. Although the gold-standard treatment of Peyronie's disease is surgery in the stable phase, nonoperative management is preferred by some men and is the only treatment option in the acute phase of the disease, when surgery is contraindicated. No oral or topical therapy has been shown to be efficacious when administered alone, but some evidence supports their use as part of a combination therapy regimen. Intralesional therapies, particularly collagenase clostridium histolyticum (CCH), have shown promise. Mechanical therapies can provide benefit when applied for prolonged periods of time, improving penile curvature, indentation, and even restoring length. Regardless of the modality chosen, patient counselling is paramount, as recovery of the penis to its predisease state is highly unlikely. Thus, although many options exist for nonsurgical management of Peyronie's disease, surgery remains the best option for men who desire the most reliable and rapid pathway to a functionally straight, erect penis. The goal of nonsurgical therapy should be a scientifically feasible, safe approach to prevent the progression of, or reduce, deformity and improve sexual function.