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Interview With Dr. Paul Perito

(January 2015)

Dr. Paul Perito is an expert in erectile dysfunction and penile implant surgery.

Dr. Gianni Paulis Peyronie's specialist
Dr. Paul Perito

As Chairman of Urology at his primary hospital, Coral Gables Hospital, Dr. Perito has completed well over 4,000 penile implants, establishing Perito Urology (in 2005) as one of the top centers in the world for the treatment of erectile dysfunction.

During this time, Dr. Perito developed a technique for penile implantation regarded as one of the most expedient and efficacious available (The Perito Implantâ„¢).

Perito Urology offers a spectrum of services that include the treatment of Peyronie’s Disease and all other forms of urologic care related to erectile function and men’s health.

Dr. Perito is an active member of the American Urological Association and the Sexual Medicine Society.

Please tell us a little bit about your background and your experience of treating patients with Peyronie's disease

I have been the number 1 penile implantor in the world for the last 10 years.

Roughly, how many Peyronie's patients do you treat each year?

We do over 500 implants/year and nearly 25% of these patients have Peyronie's. Another group seen in our office, which includes patients with Peyronie's who are not going to surgery.

What is the average age of your Peyronie's patients?

58 years

Approximately, how many of your patients fall into each of the following groups: mild, modern, and severe Peyronie's condition?

10%, 10% and 80%

How common do you think Peyronie's is? Do you think it is on the rise, e.g. due to lifestyle changes or environmental issues, or are men becoming more open about seeking assistance?

More common than previously thought. Must consider more "vigorous" sexual activity.

In your opinion, are some men more likely than others to develop Peyronie's disease?

Yes, men who are more frequently and aggressively sexually active.

How important is early diagnosis in your opinion? Can men expect better results the sooner they start treatment and why?

Extremely important, days can make the difference.

Can you describe the non-surgical treatments you recommend to your patients? What influences which treatments you recommend?

Colchicine, Trentyl and vacuum device with aggressive rehab although new data suggests the meds do not help.

What do you consider satisfying result from non-surgical Peyronie's treatment?

Because I am an implantor the patient must be perfectly straight when completed. I also push them quickly to surgery in order to avoid more loss of length.

What oral medication do you recommend to your patients and why?

See question 8.

What is your view on using supplements as part of Peyronie's treatment plan?

I do not.

Have you used Xiaflex and / or Verapamil injections? If so, what is your experience of them? How does Xiaflex compare to Verapamil in your opinion?

Yes, I have used both. I believe the disruption of the plaque with the needle might actually be the only efficacious part of this procedure.

Some clinical studies on injection therapies have shown improvements in patients in the placebo groups. This has led some to believe that injecting needle into the Peyronie's plaque may be beneficial on its own. What is your view on this?

See question 12.

Have you recommended using traction device or penis pump to treat penis curvature? If so, what is your experience of them? When do you recommend using each device?

The devices are cumbersome and patients who do use them tend to be difficult and odd.

What do you recommend for men that also suffer from low erection quality / erectile dysfunction?

Implant.

Approximately how many (%) of your patients do not respond to non-surgical treatment and therefore require penis surgery? Have you been able to identify any common characteristics among those patients?

80%. If they are under 50 they stand a chance for conservative management.

What types of surgery do you perform and what is your experience of each?

Inflatable penile prosthesis with modeling and the scratch technique.

There is some risk involved with any surgery. In your experience, how common are serious side effects after penis surgery (e.g. erectile dysfunction, penile shortening, reduced penile sensation, loss of elasticity)?

For the aforementioned procedures the only real risk is infection < 1%.

For patients that have undergone surgery to treat their Peyronie's disease, do you recommend some post operation treatment for them? If yes, what do you recommend?

The patients have to be responsible for their post operative rehab. Please see the videos Opens in new window symbol on my website for the laundry list.

What do you recommend that men with Peyronie's disease should do (or not do) to prevent the disease from getting worse?

Extensive rehab with VED and early implantation.

How do you address the emotional side of Peyronie's? What can men do to deal with the distress caused by the disease?

Early implantation limits the loss in penile length.

In your opinion, how can partner or friend best support man with Peyronie's disease?

Support him in early and aggressive management.

What can be done to raise the awareness of Peyronie's, both among the public and health professionals?

Let the public know that patients with Peyronie's disease will lose between 0.5 and 5 cm. every year.

What does the future hold for Peyronie's patients? Are there any interesting new treatments on the horizon (short term and long term)? Do you think Peyronie's will ever become curable?

Watch the Scratch Video Opens in new window symbol on my website, exciting. .

Dr. Paul Perito, thank you very much for taking the time to do this interview with My Peyronie's. For more information about Dr. Perito, visit Perito Urology Opens in new window symbol.

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