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Peyronie's Questions And Answers

›› ›› Peyronie's Questions And Answers

This section contains questions from My Peyronie's readers to Dr. Paulis and his answers. Click on the questions in the list below to see the question details and Dr. Paulis answer.

Questions to Dr. Paulis

Treatment Plans

Xiaflex

Traction Therapy

Peyronie's Symptoms

Erectile Dysfunction

Sex

Newly Diagnosed

Not Been Diagnosed Yet

Other

 

Treatment Plans

Oral Medication & Traction Therapy

Anton (Austria) January 28th 2015

How long have you had PD? 12 years

Have you seen a doctor? Yes

Describe your condition briefly: 30 years old Scar tissue - bend of penis upwards of around 30 Degrees pain (inflammation feeling) all the time (not only while erect) ED Beginning Dupuytren's in Right Hand.

Describe treatment to-date: 2,5 mg Cialis for one year every day, Potaba for 7 month, Tentral (800mg) for 6 Month now one month 1200mg, acupuncture, Penis Stretcher (Phallosan Forte) for about 4 Month.

Your question:

1) Is it worth using all these medicine at the same time (Potaba, Trental, Cialis) or should I get rid of one of those. I´m checking my blood results regularly. Doctor's don´t find anything in the blood - so it seems I go along with all this medicine quite will...

But it doesn´t really help - gets worse very slowly...

2) I used the Phallosan Forte for quite a while. But now I have the feeling that I have developed a very little plaque right where the Penis comes out of the body – so exactly where the belt of the Penis stretcher sits. Also Pain there - so I stopped with phallosan.

What would you suggest - Possible that it gets worse using the Phallosan?

Thanks,
Anton

  • Dr. Gianni Paulis January 29th 2015

    Potaba is effective to treat PD but certainly it is quite toxic. Cialis is used to treat erectile dysfunction (but not Peyronie’s disease). I don’t think that penis stretcher is indicated in a PD that began 12 years ago.

    However, to make an accurate diagnosis and then to decide a cure you should undergo an ultrasound penile study.

    Dr.Gianni Paulis

  • Birgir January 29th 2015

    Dear Anton

    If you feel your current treatment is not working, then you should go through your treatment plan with your doctor again and see if any changes should / can be done to your treatment. You may especially want to question the use of Potaba and Trental together, especially as Dr. Paulis points out, Potaba is quite toxic.

    While Cialis is used to treat different condition, i.e. the ED. You can discuss other Erectile Dysfunction Treatment Opens in new window symbol options with your doctor, like vacuum pumps, hormone therapy, etc.

    Traction therapy is generally considered safe treatment. However, if you feel pain then you should stop and discuss it with your doctor prior to continuing your treatment. Does traction work for PD that began 12 years ago. Dr. Paulis doubts it but not all agree there.

    In this video Dr. Levine says that the best curvature correction he has witnessed was in a man with 70 degrees calcified plaque that in 6 months managed to get the penis straight. I would have found that hard to believe if coming from anyone else than him!

    Dr. Levine Traction Video Opens in new window symbol is the first video under Physician Videos. You may have to register to view the video but it is free to view.

    I hope this helps somewhat and wish you good luck with your treatment. I hope you keep us posted about your progress, e.g. would be great to hear what your doctor recommends now.

    Kind regards,
    Birgir

Neprinol & Phallosan

Pelle (Sweden) April 16th 2015

How long have you had PD? 13-14 years

Have you seen a doctor? Yes

Describe your condition briefly: Hi my name is Pelle I am 38 years old I got my first diagnosis at 25 went pretty well then, ate only e-vitamin, now I have it back in a new place.

Describe treatment to-date: E-vimin and just started use Neprinol.

Your question:

Hi Dr Paulis!

It has gone now about 18 months it came back, it sits on top last time the side.
Do not have so large curvature, part narrowing and a little shorter.

Looking to start stretching device Phallosan, but I am worried that make it worse, when the last time was pretty good, is there a risk of damaging the tissue when you stretch the penis and could easily get back Peyronies?

The doctor I met last wrote neither Pentoxifylline or L-Arginie to me, but I have bought Neprinol, What do you think about Neprinol?

Grateful for answers with best regards Pelle

  • Dr. Gianni Paulis April 16th 2015

    1. The use of penile extender is recommended in the early first stage of the disease. This is not the case.

    2. I haven’t experience with Neprinol in the treatment of PD. There are no clinical trials that demonstrate the efficacy of Neprinol to treat PD.

    Dr.Gianni Paulis

  • Birgir April 16th 2015

    Dear Pelle

    Like Dr. Paulis, I don't have experience of Neprinol but this article looks at the most common supplements used by Peyronie's patients, including Neprinol.

    Does traction like Phallosan work for Peyronie's disease that began long time ago like in your case. Dr. Paulis doubts it but not all specialists agree there and Dr. Levine is one of them (this article contains video with Dr. Levine that I recommend watching)

    I hope this helps somewhat and wish you good luck with your treatment. I hope you keep us posted about your progress.

    Kind regards,

    Bigir

Dr. Levine Treatment Plan

Peter (UK)June 27th 2015

How long have you had PD? 18 months

Have you seen a doctor? Yes

Describe your condition briefly: I have a mild type 2 diabetes, which I control with diet and exercise. I suffer with ED and peyronies bend to the left by 40 degrees

Describe treatment to-date: Viagra for ED but not working great. Just bought vacuum pump

Your question:

Would you agree with Dr Levines oral (Pentoxifylline and L-Arginine), injection (Verapamil or Xiaflex), traction/vacuum approach?

  • Dr. Gianni Paulis June 28th 2015

    I don’t know in detail your condition, as it knows the doctor who is treating you.

    I can not give an opinion. However, in a very general way I approve a treatment that includes oral pentoxifylline, oral arginine and verapamil injections.

    Dr.Gianni Paulis

Dr. Paulis Recommendation

RK (USA)November 25th 2015

How long have you had PD? 11 months

Have you seen a doctor? Yes

Describe your condition briefly: 45 degree curvature. Still progressing.

Describe treatment to-date: I've had two weeks of C02 injections, 2'weeks of sonic treatments and now just had a second round of Xiaflex treatment. 2 more rounds to go. Not currently but was taking Pentoxifylline 400 mg 3 times a day

Your question:

I'd be interested in finding how you would treat me if I could travel there. Let's say I'm still progressing. What have you had most success with? Would that be Trental intralesional injections?

  • Dr. Gianni Paulis November 25th 2015

    Dear patient,

    Pentoxifylline treatment with penile injections associated with oral antioxidants is showing good results. Let me know your clinic situation after you have finished treatment with Xiaflex.

    Don’t take Pentoxifylline at the same time you are treated with Xiaflex, it could be very dangerous and would favor bleeding.

    Greetings

    Dr. Gianni Paulis

The Wait & See Approach

M (USA)November 24th 2016

How long have you had PD? 2 years

Have you seen a doctor? Yes

Describe your condition briefly: Unhappy with current situation, felt it could have possibly been avoided to some degree.

Describe treatment to-date: Had series of Xiaflex (3)

Your question:

I had seen the Urologist almost 8-10 months earlier and complained that I had the most intense pain in my penis.  If felt like a nerve ending on fire. He never addressed it. Moving forward a year later, I had full blown Peyronies. He said the pain from a year earlier was the beginning stage.  I was very angry he did nothing for a year until it was at its worst.  He claims there is nothing you can do until it's at its worst.  I think that's nonsense and would like your feedback.

  • Birgir November 24th 2016

    Dear M

    I did send your question to Dr. Paulis. As I expected he does not feel he can comment on your particular situation as he does not know your condition. He can only say what his approach is when men come to him but basically he always performs "Echo-color Doppler and then decide eventually a care with Antioxidants and Pentoxifylline".

    However, as there is no one treatment for Peyronie's disease not all Urologists recommend the same approach and unfortunately too many (my layman opinion, I'm not a medical doctor as stated on my website) still recommend what I call the "wait & see" approach (as your doctor did).

    I personally disagree with this approach as heard from too many men in similar situation as you are now, i.e. their condition did deteriorate and required invasive and expensive treatment, sometimes with not satisfying results.

    Even though there is no cure for Peyronie's, there are treatment options. There are no guarantees and no one knows if your situation would have been different if you had tried some non-invasive treatments, like Pentoxifylline or traction therapy. But in my opinion it would still have been worth trying as less invasive, less costly and has helped many (though not all) men to get better.

    I sincerely hope your Xiaflex treatment will work well for you and I hope you will keep me posted about your progress.

    Kind regards,

    Birgir

Shock Wave Lithotripsy (ESWT)

RD (USA)April 5th 2017

How long have you had PD? 12 years

Have you seen a doctor? Yes

Describe your condition briefly: Several plaques

Describe treatment to-date: Vitamin e at start

Your question:

Has anything like shock wave lithotripsy for kidney stones ever been tried or considered to break up the plaques? It would seem to me that just breaking apart the plaques may result in positive results...thanks

  • Dr. Gianni Paulis April 11th 2017

    Dear patient, several scientific articles have demonstrated the ineffectiveness of lithotripsy (ESWT) as treatment of Peyronie's disease. 

    Regards

    Prof. Paulis

Maintaning Results

huberd (USA)June 8th 2017

How long have you had PD? 2+ years

Have you seen a doctor? Yes

Describe your condition briefly: Curvature to the right with very small indentation ...40° before treatment as measured by PD specialist.

Describe treatment to-date: After 18 months of PD that became stable/chronic, I began aggressive penile traction - 4 hours daily (90 days total traction), had 7 series of verapamil injections and added Acetyl-L-Carnitine (ALC) (1000mg 2xs per day) and pentoxifylline ER (Pentox) (400 mg 3xs per day) after the 5th series of verapamil injections. After I developed a rather severe hematoma (CT scan confirmed) that eventually dissipated after 8 weeks, I ended all verapamil injection/traction treatments at that time, given great results ...between 5° to 10° of stable PD curvature with no pain or ED. Further risks did not justify the possibility of a small reward. I have 2 months of Pentox and ALC oral medications left on my treatment plan and remain on these oral treatments.

Your question:

My question involves keeping my results. I feel so grateful to have had successfully 'recovered' from this tramatic event but want to keep my results and prevent a reoccurrance/worsening of PD.  I recently began much a less intensive course if penile traction much like wearing a dental retainer after having had braces (after 10 weeks without any traction), practice less risky/vigorous sexual practices ...including the use of slight amounts of lubrication before sex to reduce the pressure at penetration.  What are your thoughts on periodic penile traction and if recommended how often/how long?  Any supplement therapy or other medications/ recommendations to maintain my success?  Thank you for your consideration.

  • Dr. Gianni Paulis June 8th 2017

    If your situation is now stable....

    I advise to continue Acetyl-L Carnitine 1 gram per day + Pentox 400 mg x 2 daily + daily tractions for another 6 months.

    Recommended normal sexual intercourse and no vigorous sexual practices.

    Kind regards

    Dr. Gianni Paulis

Stem Cell Therapy

Drew (USA)September 19th 2017

How long have you had PD? 1 year

Have you seen a doctor? Yes

Describe your condition briefly: Two plaques. One large one on the front 1/3, right side, and one smaller one at the front bottom left side of the penis. I guess it is still in the developing stage, as it is still painful, particularly after orgasm.

Describe treatment to-date: None.

Your question:

I've found some studies that point to stem cells as a possible treatment option. What knowledge do you have of these studies, and what words of warning would you have for somebody who might seek these treatment options?

  • Dr. Gianni Paulis September 19th 2017

    Dear patient,

    I don't care Peyronie's disease using stem cell disease, but if you want, look at this site.

    Kind regards

    Dr. Paulis

Xiaflex

Xiaflex or Surgery?

PT (USA) February 25th 2014

How long have you had PD? 3 years

Have you seen a doctor? Yes

Describe your condition briefly: My curvature seemed to appear suddenly one day. There had been no previous signs. For the first few months, it was painful. Now there is no pain, but the curvature is almost 90 degrees. There is an hourglass effect, and some general size decrease. The doctors say that there are 2 plaques, a large one at the base and a smaller one near the curvature. However, I have strong erections and ejaculations, and seem to have good blood flow. Intercourse is nearly impossible.

Describe treatment to-date: I have been taking pentoxifylline since the initial diagnosis, and L-arginine almost as long. I tried potaba for a few months early on. I have had 7 or 8 Verapamil injections, approximately 1.5 year ago. Nothing seems to have had any effect thus far.

Your question: Should I try Xiaflex injections, or go straight to surgery? I understand that the injections are very expensive, and I'm wondering, with the extent of my curvature, if they would be effective. Which surgery technique would be preferable in my case? I have a followup appointment with a surgeon next month. I've been holding off on surgery, awaiting the approval of Xiaflex. I just wanted to get another opinion.

  • Dr. Gianni Paulis February 26th 2014

    Dear PT,

    Your disease is in an advanced stage and I believe that your only possible solution is surgery (corporoplasty). I do not recommend for you treatment with collagenase because there are possible unpleasant complications and mainly because it is not indicated in your stage of disease.

    My best wishes,

    Dr.Gianni Paulis

    • PT (USA) February 28th 2014

      Thank you for so promptly responding to my previous question, regarding surgery vs xiaflex.

      You recommended surgery. A couple of follow up questions: You mentioned that Xiaflex had some negative effects. Out of curiosity, what are those? Secondly, should I continue taking pentoxifylline & L-arginine, or is that a waste of money? I have seen no change, and I have been on those for nearly the entire 3 years.

      Thank you.

    • Dr. Gianni Paulis February 28th 2014

      Dear PT,

      Your case is in an advanced stage of the disease and the correct indication is only surgery. Medical therapy is not needed at this stage of the disease.

      Side-effects exist, but I prefer that you read them directly on a web page of the industry Auxilium Pharmaceuticals, owner of Xiaflex.

      This is the link: Xiaflex Side Effects Opens in new window symbol

      Greetings,

      Dr.Gianni Paulis

Stable Peyronie's Phase And Xiaflex

Steve (USA) April 2nd 2014

How long have you had PD? 3 years.

Have you seen a doctor? Yes.

Describe your condition briefly: 90 degree curvature. Plaque at base and center of penis.

Describe treatment to-date: Traction device, pen., cialis and trimix 30mg injection prior to sexual activity.

Your question: What is your thoughts on Xiaflex for treating of Peyronie's? I am 56 years old.

  • Dr. Gianni Paulis April 4th 2014

    Dear Steve,

    I do not recommend Xiaflex for tx (treatment) of Peyronie's (see previous answers).

    What is the report of your dynamic penile ultrasound study?

    Therapy depends on the stage of Peyronie's disease.

    My best wishes,

    Dr.Gianni Paulis

Can't Afford Xiaflex, What Else Can I Do?

Gerald (USA) September 7th 2014

How long have you had PD? About 10 months

Have you seen a doctor? Yes.

Describe your condition briefly: No pain anymore, 90 degree bend

Describe treatment to-date: Just a ultra sound

Your question: My doctor wants to use Xilaflex, will this work, I am having a problem getting the drug to my doctor because of insurance,what else can I do.

  • Dr. Gianni Paulis September 7th 2014

    Dear Gerald,

    You should inform your doctor about this situation. However, you could use Verapamil or Pentoxifylline.

    My best wishes,

    Dr.Gianni Paulis

Traction Therapy

Traction Therapy For Upward Curvature

Bill (USA) July 31st 2014

How long have you had PD?

Diagnosed a year ago July 2013

Have you seen a doctor? Yes

Describe your condition briefly: Upward bend, sustained scar tissue on left side of penis base from cyscoscopy

Describe treatment to-date: Had a sonogram in 2013. Seen  three different urologist two basically educated me about the unsuccessful  treatments and subscribed cialis, I left them feeling doomed. The third doctor was a bit more optimistic and spoke about the drug recently approved the FDA Xiaflex

Your question: I really do not want to result to surgery, I'm considering traction therapy, but the devices that I've seen thus far are for left or right curvature. I have a upward curvature and the penis size has shorten in length and reduction in width. If I decide to go this route, I'm not sure I can't seem to locate a device that caters to the upward curvature?

  • Dr. Gianni Paulis July 31st 2014

    Dear Bill,

    Traction device only for the very early stages of the disease and in combination with antioxidants

    My best wishes,

    Dr.Gianni Paulis

  • Birgir

    Dear Bill,

    Dr. Paulis is on a holiday so he asked me to answer you about the difference between traction devices.

    Traction device will lengthen the penis if used over extended period of time. That's just how traction works (think of long neck Kayan women in Burma). It however does require commitment. You can realistically expect between 0.5 – 1 cm in penile length per month of use. So to increase your penile length by 1 - 2 inches (2.5 – 5 cm) you are likely to have to use the penis traction device for 6 - 10 hours daily for 3 - 6 months.

    Traction therapy can also help some men with reducing their penile curvature (though no guarantees there as can depend on the individual condition). This article explains how Traction Works For Men With Peyronie's.

    This is My Personal Story but I used traction device to successfully treat my Peyronie's disease.

    And this is a story from one of My Peyronie's Reader that used traction to help him improve his curvature and gain back lost length. He says " When I had a 90% bend, and had lost 2 inches, having sex was very difficult, now that I have an inch and a half back and the curve is down to about 45 degrees, sex is fine, but I am going to continue to see if I can't get back more than I started with and get it almost straight. This takes a serious commitment!!"

    While this article explains The Difference Between Traditional Traction Devices And Those That Allow You To Control The Direction Of The Traction. There are photos that show how to deal with left and right penile curvature, as well as upward and downward curvature, i.e. you fold the device up towards the body if the curvature is downwards, but down away from the body if the curvature is upwards (like in your case).

    As your curvature is not to the side, you can use traditional penis device as such (though both Andropeyronie and The Peyronies Device also work as traditional device). I have reviewed number of traction devices and you can see My Peyronie's Reviews here.

    I hope this is some help but feel free to contact me anytime if you think I can be of any further assistance. I would also appreciate if you keep us posted about your progress.

    Best regards,

    Birgir

Traction Therapy For Men With No Curvature

Ryan T (USA) September 6th 2014

How long have you had PD? 3 Months

Have you seen a doctor? Yes

Describe your condition briefly: Painful erections, can feel hard lumps in the center of my penis in 2 different locations, no curvature, doctor said because of locations of plaque is in the middle the curvature is not present, but I noticed an indention on bottom of shaft.

Describe treatment to-date: Vitamin E

Your question: Since I do not have curvature, will a penis traction device still help me with breaking up plaque or scar tissue if it is in center?

  • Dr. Gianni PaulisSeptember 6th 2014

    Dear Ryan T,

    If the disease is really started three months ago (???) traction device could be useful but only if it is associated with drug therapy.

    Dr.Gianni Paulis

  • Birgir September 6th 2014

    Dear Ryan T,

    Traction therapy has helped many men with their Peyronie's disease. Most though start using it to help with penile curvature but as Dr. Paulis points out it can be helpful as part of any Peyronie's treatment, especially early on in the disease.

    I recommend you see your doctor again and go through your options with him.

    I don't know if you have already seen my articles about traction device but just in case, I'm attaching links to those that may be helpful read for you at this stage.

    This article explains How Traction Device Works for men with Peyronie's disease.

    These are My Reviews Of The Most Popular Brands. I have personally tested some of them. I do recommend either Andorpeyronie or The Peyronies Device for men with penile curvatures (it also works for others). However, I do like the Male Edge best of the traditional devices, as it is light, convenient to use and easy to extend. While Phallosan is also an interesting option, especially for those that want to sleep with the device (it's the only safe device to wear while sleeping).

    This is a Personal Story Of Using Traction Device to treat Peyronie's disease from My Peyronie's reader. And this is My Story but I used traction to treat my Peyronie's.

    I hope this helps but if you have any further questions, don’t hesitate to be in touch. I wish you all the best with your treatment.

    Best regards,

    Birgir

Peyronie's Symptoms

Peyronie's Pain

JA (USA) November 11th 2014

How long have you had PD? 2 Years and 5 Months

Have you seen a doctor? Yes

Describe your condition briefly: I have Peyronies disease at the base of my penis. It is in a half circle around the base favoring the right side.

Describe treatment to-date: I have tried Colchicine with Vitamin E

Your question: I am writing to ask you about Peyronies pain. I spoke with my doctor but I wanted to ask you as well for a second opinion. I am now almost 2 1/2 years post diagnosis. The area where the plaque is located is sensitive to the touch meaning that any applied pressure results in a sharp pain. I also have a bump in that spot. Finally I experience a random stinging sensation in that area once in while. Is this normal so many years after diagnosis. Can pain and inflammation still be normal this far in the game? Thank you for your time and help.

  • Dr. Gianni Paulis Novermber 11th 2014

    Presence of penile pain simply means that the disease is still (and despite treatment) in active and acute phase. The performed treatment has only slowed the progression and speed of PD.

    King regards
    Dr. Paulis


Flaccid Penis Pain

Adam (Germany) February 2nd 2016

How long have you had PD?4 years and 7 months

Have you seen a doctor? Yes

Describe your condition briefly: Curvature 10-20 degrees, small plaque= 0,8 mm, but annoying discomfort and hot/cold-burning sensation.

Describe treatment to-date: Pentox, potaba, coq10, blueberries, ginger, Propolis, infrared-heat 150 Watt three times a week for 20 minutes.

Your question: My discomfort interferes with my daily-life so much. I want to know, what i can do, to reduce my discomfort when flaccid to keep my my family and my job.

  • Dr. Gianni Paulis November 12th 2014

    I believe that your PD is now stabilized (note the size of the plaque 0,8 mm and the onset of PD ........more than 4 years).

    I think that your symptoms are caused by a chronic prostatitis. I recommend you have: prostatic ultrasound, culture of seminal fluid and spermogram.

    Regards
    Dr.Paulis

  • Birgir February 2nd 2016

    Dear Adam

    I'm very sorry to hear about your serious discomfort.

    Peyronie's caused penis pain usually goes away when men reach the stable phase. So please take Dr. Paulis advice and see your doctor to find out if there is some other cause for your pain.

    I wish you all the best in the future.

    Kind regards,

    Birgir


To list of questions

Erectile Dysfunction

Erectile Dysfunction

Richard (USA)December 13th 2014

How long have you had PD? 17 years

Have you seen a doctor? Yes

Describe your condition briefly: I have Peyronie's though not as severe as I've seen in internet photos it's probably between 11degrees and 13 degrees to the left when I was younger it never bothered me since it got so firm when erect, I have ED now and it's only about 50% firm not quite enough to have sex.

Describe treatment to-date: No Dr has prescribed anything I've only had the libido addressed via Ceallis and Viagra and Testosterone injections.

Your question: Can my condition be improved to when I have sex?  I'm not too careful as to harm my penis and give her satisfaction? In other word is Peyronie's curable? Have you witnessed improvement in your patients? Last should I continue getting penis injections to maintain erection for adequate sex life?

  • Dr. Gianni Paulis December 13th 2014

    Dear patient,

    If you have had Peyronie’s disease at the age of 17 years, the disease is most likely stabilized and concluded. So the only thing to do is to treat your erectile dysfunction with PDE-5 inhibitors (Viagra, Cialis etc) or others (PGE-1 injection, vacuum device etc). Go from a Andrologist for a consultation and prescription.

    Best regards

    Dr. Paulis


To list of questions

Sex

Abstaining from sex

Ashraf (Egypt)May 12th 2017

How long have you had PD? 4+ years

Have you seen a doctor? Yes

Describe your condition briefly: I have a mild case of peyronie's disease with around 15 degrees curvature caused by several dents on the right side of the penis shaft. The ultra sound shows several small areas of fibrosis along both corpora cavernosa.

Describe treatment to-date: I have been undergoing treatment for around 5 months. it is mainly oral treatment till now, with no injections and no traction therapy. the oral medication included Colchicine, Arcoxia, Vitamin E 1000, Alphintern, Celebrex, and Mobic. They were not given during the same times, for example 2 months of Colchicine, Arcoxia, and Vit E and other times with Alphentern, Celebrex, and Mobic.

Your question: Hello Dr. Paulis,

My question is about the sexual activity during the treatment of peyronie's disease. My urologist advised that I completely abstain from all sexual activity including masturbation and intercourse and even to try to avoid erections all together, because they all cause trauma to the penis. It's been 5 months now since I started treatment and I am finding it very difficult to follow this advice. So I wanted to get a second opinion.

Also he advised against penile traction devices since the traction also causes trauma to the penis. So I want to get your opinion regarding this as well.

  • Dr. Gianni Paulis May 12th 2017

    Dear patient,

    Sexual activity is not contraindicated during the treatment of the disease.

    However, I do not agree to the use of traction devices during this disease, in fact they can really cause a penile trauma.

    Best regards

    Dr. Paulis

  • Birgir Gislason May 12th 2017

    Dear Ashraf,

    I must admit that I found the advice your doctor gave you quite surprising. I have not heard anything like this before, i.e. to abstain from sexual activity (and to try to avoid erections at all... not an easy task!).

    However, I believe men should take reasonable precautions when having sexual intercourse, i.e. avoid positions that put awkward strain on the penis as it can lead to penis injury / aggravate the Peyronie’s condition. Also, to make sure the erection is firm enough before having intercourse, i.e. to avoid penis buckling. But abstaining from sex, never heard that and personally don’t think it is a good idea. Sex is not only physical nor is Peyronie’s disease. Men suffering from Peyronie’s disease are prone to depression and abstaining from sex is likely to affect the Peyronie’s patient psychological state negatively.

    Not everyone agrees with Dr. Paulis opinion of traction devices, including Dr. Levine, one of the best-known specialists in Peyronie’s disease which has used them extensively as part of his non-surgical treatment plan. I personally used traction device to treat my Peyronie’s and I personally would do so again. I have just heard too many success stories and no stories of penile trauma resulting from the use of traction devices.

    Most Peyronie’s treatments have some side effects and I personally consider traction therapy as one of the safest, least invasive and cost effective treatment option for men with mild / moderate penile curvature. However, often best used with other treatment options. This article offers overview of the most common treatment options today.

    Everyone must evaluate the pros and cons of each treatment option and take his own decisions. Maybe you want to seek second opinion?

    I hope this is of some help and wish you all the best with your treatment.

    Kind regards,

    Birgir

Newly Diagnosed

Newly Diagnosed, Should I Wait And See Like My Doctor Adviced?

Georgia (USA) March 24th 2014

How long have you had PD? 3 1/2 weeks that I'm aware of

Have you seen a doctor? Yes

Describe your condition briefly: Slight indentation across top of erect penis that appears as a "break" in the top and will buckle or bend slightly when applying upward pressure to erect shaft. This was explained as adhesions or scar tissue on top of the penis. Also a hard pea-size lump in middle of shaft base. Some slight discomfort (real or imagined) when intimate.

Describe treatment to-date: Essential oils topically, Natto-K

Your question: The urologist I saw yesterday said it was Peyronie's, but gave no advice or prescriptions, told me that it "might" get worse, but not to worry about it and go home and have fun since to this point it's not interfering with my love life. As I believe I'm in the acute phase and only discovered the lump and bend in the last month, I am concerned about things possibly getting worse and would like to do everything possible to prevent that or to reverse any damage. Can you advise?

Also, I was wondering if there's some kind of "splint" one can wear during intercourse to support the base and prevent buckling!

Thank you so much!

  • Dr. Gianni Paulis March 24th 2014

    Dear Georgia,

    I cannot give you any advice as there's not a clear diagnosis. I advise you to search for a secure diagnosis, then you should perform dynamic penile ultrasound study.

    My best wishes,

    Dr.Gianni Paulis


Newly Diagnosed, Only taking Vitamin E - What Should I Do?

Gerald (USA) June 1st. 2014

How long have you had PD? 4 months

Have you seen a doctor? Yes

Describe your condition briefly: Curve is about 50 degrees most of the pain is gone. It started with a hour glass shape at the base and a slight curve with pain and a hard lump at the base that has gone away. I have been taking Vitamin E.

Describe treatment to-date: I have been taking Vitamin E

Your question: What should I do?

Thank you so much!

  • Dr. Gianni Paulis June 2nd 2014

    Dear Gerald,

    It is important to make an accurate diagnosis, so I recommend you to undergo an ultrasound penile dynamic.

    My best wishes,

    Dr.Gianni Paulis

  • Birgir June 4th 2014

    Dear Gerald,

    You say you have seen a doctor but you don't say what he recommended. This is why Dr. Paulis recommends you have ultrasound penile dynamic done. The result of it will determine what is the best treatment option for you and also will help your doctor to monitor your progress.

    It sounds like your doctor didn't recommend any treatment for you, or the "wait and see" approach, i.e. when doctors tell their Peyronie's patients to take Vitamin E and wait and see and hope the situation does not get worse.

    Most Peyronie's specialists now agree that this is not a good approach. It is estimated that between 5-15% of Peyronie's patients improve without any treatment. The remaining either stay the same or gets worse, even lot worse. This is why time is important when dealing with Peyronie's disease, the sooner men start treatment, the better results they can expect.

    Most specialists now agree that Vitamin E does not improve Peyronie's... though many still take it on "cannot hurt basis".

    So I recommend you see another doctor a.s.a.p. Try to find someone with experience of Peyronie's disease. I cannot recommend any doctor but the APDA website offers Physician finder that may be helpful in locating experienced doctor near you.

    Physician Finder Opens in new window symbol

    Ask him to perform ultrasound penile dynamic. And ask him about the different non-surgical treatments options. This article compares the different treatment options and may help you to identify those of interest to you.

    Peyronies Treatment Comparison

    You might be good candidate for the combined treatment plan recommended by Dr. Levine, one of the best know Peyronie's specialists in the world today.

    Recommended Peyronies Treatment Plan

    Even traction therapy on its own may help you to reduce the curvature. It is one of the cheapest treatment options available and something you can start immediately. You have nothing to lose by trying traction but hopefully lot to gain.

    Penis Traction Devices

    I hope this help. I would appreciate if you kept us posted about your progress.

    Best regards,

    Birgir

Not Been Diagnosed Yet

Not Been Diagnosed With Peyronie's Disease

Gregoryn92 (USA) May 18th 2014

How long have you had PD? 2 weeks

Have you seen a doctor? No

Describe your condition briefly: I'm 21, and I was sitting in my room with my girlfriend studying. I got about a 90% erection and since she was on her period, we couldn't have sex. I thrusted pretty hard directly on her and felt a little pain. Nothing serious, but I noticed an extremely small indentation on the left side of my penis shaft. I have noticed no curvature or shortening of penis yet, and have been monitoring it for days now. I experience no pain when I have an erection... only in the mornings when it becomes flaccid.

Describe treatment to-date: I have been eating a lot of cliff bars that have a high amount of Vitamin E in them.

Your question: Is this an acute early stage of Peyronies? I'm young and I don't want to lose length or have a curved penis the rest of my life.

  • Dr. Gianni Paulis May 20th 2014

    Dear Sir,

    It is necessary to perform an ultrasound penile dynamic study. Your symptoms are not sufficient to diagnose Peyronie's disease.

    My best wishes,

    Dr.Gianni Paulis

  • Birgir May 20th 2014

    Dear gregoryn92

    As Dr. Paulis points out you need to see a doctor to get a formal diagnosis. You should do so a.s.a.p. as time is important if you have Peyronie's disease. The sooner you start treatment the better results you can expect, and the less likely you are to lose length or have a curved penis the rest of your life.

    So please act now. Hopefully this is nothing to worry about.

    Best regards,

    Birgir

Peyronie's Disease Or Not?

Vamp (India) July 23rd 2014

How long have you had PD? More than a year or so

Have you seen a doctor? No

Describe your condition briefly: My penis is curved to the right. I do not have pain during erection ejaculation or urination, but it causes a slight pain when turned to the left side when not flaccid. I do not know how long I have had this. I am not sure if I do have pd for sure as I have not consulted any doctors regarding this. My age is 20.

Describe treatment to-date: No treatment so far.

Your question: Is it serious?? Should I consult a doctor? What other ways are there for me to cure or reduce plaque?? Reply asap.

  • Dr. Gianni Paulis July 23rd 2014

    Dear Sir,

    To diagnose and eventually to treat Peyronie's disease is necessary to perform a penile ultrasound. Without a diagnosis, no cure is possible!

    My best wishes,

    Dr.Gianni Paulis

  • Birgir July 23rd 2014

    Dear Vamp

    As Dr. Paulis says, you need to see a doctor and the sooner the better. You need to find out if you really have Peyronie's or something else, for example Genital Curvature.

    However, if you have Peyronie's disease, time is important. The sooner you start treatment the better results you can expect to see. This article contains overview of the most common Peyronie's Treatments today.

    This Article may help you to prepare for your doctor's appointment.

    I hope this is of some help. Don't hesitate to contact me again if you have any further questions. I wish you good luck with your doctor's appointment and treatment.

    Best regards,
    Birgir

Frozen Shoulder And Peyronie's Disease

Raymond (USA) October 27nd 2016

How long have you had PD? Unknown

Have you seen a doctor? No

Describe your condition briefly: In the past month I went to my family doctor for shoulder pain. I was diagnosed with frozen shoulder. In addition I recently noticed an inward dent on the shaft of my penis. After research I came across a disease called peyronie's and in the description of peyronie's it stated that other common related symptoms result in frozen shoulder. After reading this to me it confirmed that I have Peyronie's disease.

Describe treatment to-date: As of now no treatment. I will go to the store tomorrow and purchase vitamin E. At this time there is no pain but the inward dent is causing a high concern.

Your question: Should I be worried? What treatment would you recommend for an inward dent.

  • Dr. Gianni Paulis October 27nd 2016

    Dear Patient,

    The shoulder disease has other origins. You don’t worry… this is a treatable disease.

    I don’t recommend any treatment, because now, before treatment, it is required an accurate diagnosis. I advise you to undergo a dynamic penile echo-color-doppler .

    Then, you will have to submit to a visit with an Andrologist that will decide the right therapy for the condition of that moment.

    Best regards
    Dr.Gianni Paulis

  • BirgirOctober 27nd 2016

    Dear Raymond

    As Dr. Paulis says you should see a doctor that specializes in Peyronie's disease to get formal diagnosis and discuss your treatment options.

    As you point out, there may be connection between Peyronie's disease and some other disease like Dupuytren's, Ledderhose and Frozen Shoulder. There is a website and closed Facebook Support Group Opens in new window symbol especially for people with those diseases that you may want to check out.

    I hope this helps and wish you all the best with your treatment.

    Kind regards,

    Birgir

First Visit To A Peyronie's Doctor

Peyroniesissues100 (USA) October 27nd 2016

How long have you had PD? 1 and a half years

Have you seen a doctor? No

Describe your condition briefly: About a year and a half ago I noticed that my erections were forming a hourglass shape at the beginning stages of arousal. This happened mostly after exercise or cold weather. I did not think it was a problem at the time because my erections were fine. Recently I noticed that there was a distinct dent on the middle right side of my penis. When I became erect, I could feel that the spot was softer than the rest of my penis and slightly "caved" in. The left side of my penis was slightly more engorged while my right side felt slightly softer. I finally was smart enough to realize that I needed help with this and set up a doctors appointment. There is no curvature or pain. Also the hourglass shape became drastic at the beginning of arousal.

Describe treatment to-date: None. I have an appointment set up.

Your question: Any advice or things you recommend I mention to my doctor?

  • Dr. Gianni Paulis October 27nd 2016

    Dear Patient,

    To make an accurate diagnosis it needs a penile dynamic echo-color-doppler. According to ultrasound appearance of penile plaque it will be able to choose a targeted care.

    Regards
    Dr.Paulis

  • BirgirOctober 27nd 2016

    I'm sorry to hear about your condition but it is great that you are seeking medical advice. Hopefully you can use some of the tips in this article to help you to prepare for your appointment.

    In the meantime, make sure you take care when having sexual intercourse as hourglass shape increases somewhat the risk of buckling which could aggravate your condition further.

    I wish you all the best with your appointment and treatment.

    Kind regards,

    Birgir
    www.MyPeyronies.com

Peyronie's And / Or Prostatitis

MO (UK) April 5th 2017

How long have you had PD? I Don't Know

Have you seen a doctor? Yes

Describe your condition briefly:

(18months) I have had painful urination since September 2015, the pain is felt in the tip of penis, in the head on the left hand side. If I roll the head of my penis in my fingers I can feel a small lump on the left and side, very small, this hasn’t changed in size since the start of the problem. I can trigger the same pain by pressing into my urethra underneath my scrotum towards my perineum., I feel the pain in the point where I’m pressing and the head of my penis.

(11 Months) – I have been experiencing erectile dysfunction since May 2016. I can now get an erection most of the time, at points I couldn’t even get one, now I can get one but rarely maintain it lost is 5/6 times. Still difficult to get what I consider a full erection. My erections are shorter, less firm. Penis feels like its straining to reach full size, like it’s full but it doesn’t look full, it’s hard to explain. My flaccid penis often feels very small and like it’s being pulled backwards from inside me, making it shorter. Occasionally I have felt pain in my penis, both flaccid and erect. When erect now it will often ache, I’m not sure if this is because it’s rarely erect any more or what. Pains when flaccid are quiet sharp pains. Whilst when erect it’s more of an ache.

Recently when examining my penis I felt a small lump along my urethra, about half way up. Also the tip of my penis often feels numb, number than the shaft which is unusual I guess?

Things to note : I am circumcised. I have a back problem, in disc l4-l5 and l5-s1, but an MRI in may 2016 showed no neural compromise. However since then I have experienced more frequent numbness in lower back and coccyx, along with discomfort in the perineum region, coccyx and ass-hole.

Describe treatment to-date:

I have seen urologists who dismissed me saying they couldn't help with the painful urination as blood tests and urine samples were normal and said the erectile dysfunction was probably psychological.

I didn't mention the lumps as I hadn't noticed them then.

Your question:

Any insight? What do you think?

  • Dr. Gianni Paulis April 11th 2017

    Dear patient,

    To get a definitive diagnosis you will have to perform penile dynamic ecocolordopller. Without this examination, it will be impossible to understand the cause of your penile problems.

    In addition, many of your other symptoms induce the suspicion of a prostatitis, tests indicated are: prostatic ultrasound, cultural examination of the seminal fluid, semen analysis.

    Greetings 

    Prof. Paulis

Other

BSopher (USA) July 13th 2017

How long have you had PD? Months

Have you seen a doctor? Yes

Describe your condition briefly:

Had hernia surgery 2 ingen, 1 umbilical all done at the same time in  2011. still having discomfort..woke up out of a dead sleep in sever pain in my penis and now I have a bend on the left side of my penis..I'm having a hard time keeping an erection. I'm smaller at the base of the shaft and the rest of my penis is normal..overall I'm now smaller in length.. is this Peyronie's disease?

Describe treatment to-date:

No treatment

Your question:

Can scar tissue from hernia surgery move into the shaft of the penis causing peyronies disease Thank you

  • Dr. Gianni Paulis July 13th 2017

    Dear patient,

    • If you want to be sure of having Peyronie’s disease, you will need to make dynamic penile eco-color-doppler.
    • Scar tissue from hernia surgery cannot move into the shaft of the penis causing peyronies disease.

    Kind regards
    Dr.Paulis

PD experience (USA) July 13th 2017

How long have you had PD? 7 years

Have you seen a doctor? Yes

Describe your condition briefly:

Dr.Paulis, you recently answered a question I had. I asked if I should have stitches removed from previous placation surgery and try injections. I have been reading Peyronies affects mostly European men with A+ blood type, I fit in that category. I have also had autoimmune diseases most of my life, from allergies, skin problems, Hodgkins Lymphoma and persistent mouth ulcers, after having ABVD treatment for the cancer. I did experience two painful attacks during erections, eight years apart, the first one in 2002, lasted only a few days but left a very slight upward curve, the second attack, in 2010 was much worse and very painful, leaving a lump at the top base of my penis and causing an upward bend and to the left indentation. If it's any help or new information, at both times, I was under extreme stress. I can't think of any damage I did to my penis to cause this.

Describe treatment to-date:

I saw three Doctors, one prescribed trental, L-Argenine, Cialis and a pump, it did nothing. The second Doctor said to just wait, sometimes it will reverse itself, it didn't. The third Doctor performed placation surgery, which has held up until now, I notice the curve coming back after five years. You suggested surgery again.

Your question:

First, thank you for your first answer. Second. Has there been any study on autoimmune disease and Peyronie’s? Does stress release any kind of hormone, that can cause this kind of damage? I really appreciate your time to answer my questions. Thank you.

  • Dr. Gianni Paulis July 13th 2017

    Dear patient,

    1) A recent study showed highly significant association from the statistical point of view between Peyronie's disease and autoimmune disorders.

    Reference: Ventimiglia E. et al. Peyronie's disease and autoimmunity—a real-life clinical study and comprehensive review. J Sex Med. 2015 Apr;12(4):1062-9. doi: 10.1111/jsm.12825. Epub 2015 Jan 29.

    2) Stress to be able to damage the tissues must be physical and not psychological

    Kind regards

    Dr.Paulis

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