Editing Peyronie's disease (section)

== Management and Treatment ==
Peyronie's disease treatment is based on stage of disease, degree of curvature, loss of function, and patient choice. Conservative management<ref>{{Cite journal |last1=Reddy |first1=Amit G. |last2=Dai |first2=Michelle C. |last3=Song |first3=Jeffrey J. |last4=Pierce |first4=Hudson M. |last5=Patel |first5=Sagar R. |last6=Lipshultz |first6=Larry I. |date=2023-02-02 |title=Peyronie's Disease: An Outcomes-Based Guide to Non-Surgical and Novel Treatment Modalities |journal=Research and Reports in Urology |language=English |volume=15 |pages=55–67 |doi=10.2147/RRU.S278796 |doi-access=free |pmc=9901485 |pmid=36756281}}</ref> in the acute phase has the aim of reducing [[inflammation]] and disease extension. Treatment can be with tablets<ref>{{Cite journal |last=Abern, M. R., & Levine, L. A. (2009) |title=Peyronie's disease: evaluation and review of nonsurgical therapy. |journal=The Scientific World Journal |date=2009 |volume=9 |pages=665–675|doi=10.1100/tsw.2009.92 |doi-access=free |pmid=19649505 |pmc=5823162 }}</ref><ref>{{Cite journal |last=Hauck, E. W., Diemer, T., Schmelz, H. U., & Weidner, W |title=A critical analysis of nonsurgical treatment of Peyronie's disease. |journal=European Urology |date=2006 |volume=49 |issue=6 |pages=987–997|doi=10.1016/j.eururo.2006.02.059 }}</ref><ref>{{Cite journal |last=Mynderse, L. A., & Monga, M. |title=Oral therapy for Peyronie's disease. |journal=International Journal of Impotence Research |date=2002 |volume=14 |issue=5 |pages=340–344|doi=10.1038/sj.ijir.3900869 }}</ref> such as [[pentoxifylline]] (an anti-fibrotic phosphodiesterase inhibitor), [[Acetylcarnitine|acetyl-L-carnitine]], and [[vitamin E]]. Mechanical treatments in the form of [[penile traction therapy]] (PTT) and vacuum erection devices (VED) are used to correct the curvature due to plaque and preserve length.

Intralesional injection therapy<ref>{{Cite journal |last1=Khooblall |first1=Prajit |last2=Bole |first2=Raevti |last3=Lundy |first3=Scott D. |last4=Bajic |first4=Petar |date=2023-06-21 |title=Expanded Utilization of Intralesional Therapies for Treatment of Peyronie's Disease |journal=Research and Reports in Urology |language=English |volume=15 |pages=205–216 |doi=10.2147/RRU.S386340 |doi-access=free |pmc=10290860 |pmid=37366388}}</ref><ref>{{Cite journal |last=Trost, L. W., Gur, S., & Hellstrom, W. J. |title=Pharmacological management of Peyronie's disease. |journal=Drugs |date=2007 |volume=67 |issue=4 |pages=527–545|doi=10.2165/00003495-200767040-00004 |pmid=17352513 }}</ref> is the mainstay of non-surgical therapy, particularly for stable disease. [[Verapamil]] and interferon-α2b have intermediate efficacy. [[Collagenase clostridium histolyticum|Collagenase Clostridium histolyticum]] (CCH),<ref>{{Cite journal |last1=Phillips |first1=Drew |last2=Chan |first2=Justin Y.H. |last3=Flannigan |first3=Ryan |date=May 2020 |title=Evaluating collagenase Clostridium histolyticum administration protocols in the treatment of Peyronie's disease |url=https://journals.lww.com/10.1097/MOU.0000000000000760 |journal=Current Opinion in Urology |language=en |volume=30 |issue=3 |pages=328–333 |doi=10.1097/MOU.0000000000000760 |issn=0963-0643}}</ref> an enzymatic drug approved by the US FDA, targets plaque collagen and repairs in moderate disease. It is administered in a series of treatment cycles with attendant penile modeling and elongation.

Surgical therapy<ref>{{Cite journal |last1=Osmonov |first1=Daniar |last2=Ragheb |first2=Ahmed |last3=Ward |first3=Sam |last4=Blecher |first4=Gideon |last5=Falcone |first5=Marco |last6=Soave |first6=Armin |last7=Dahlem |first7=Roland |last8=van Renterghem |first8=Koenraad |last9=Christopher |first9=Nim |last10=Hatzichristodoulou |first10=Georgios |last11=Preto |first11=Mirko |last12=Garaffa |first12=Giulio |last13=Albersen |first13=Maarten |last14=Bettocchi |first14=Carlo |last15=Corona |first15=Giovanni |date=2022-02-01 |title=ESSM Position Statement on Surgical Treatment of Peyronie's Disease |journal=Sexual Medicine |language=en |volume=10 |issue=1 |pages=100459 |doi=10.1016/j.esxm.2021.100459 |issn=2050-1161 |pmc=8847818 |pmid=34823053}}</ref><ref>{{Cite journal |last1=Kadıoğlu |first1=Ateş |last2=Gürcan |first2=Mehmet |last3=Rakhmonovich |first3=Abdurakhmonov Farkod |last4=Dursun |first4=Murat |date=2024-04-30 |title=Surgical management of complex curvature in Peyronie's disease |journal=World Journal of Urology |language=en |volume=42 |issue=1 |page=276 |doi=10.1007/s00345-024-04936-z |issn=1433-8726 |pmc=11061042 |pmid=38689034}}</ref> is reserved for fixed patients with severe curvature, or failed medical therapy. Operations include penile plication (shortening the concave portion of the penis), plaque incision or [[Excision (surgery)|excision]] with grafting (lengthening the convex portion of the penis), and penile prosthesis implantation in concomitant erectile dysfunction. Reasonable levels of satisfaction after surgery are present, especially with appropriate preoperative counseling.

[[File:Peyronie’s before & after comparison & traction treatment.jpg|thumb|Before (left) and after (middle) onset of Peyronie’s disease, causing an indentation near the base on the right side and a decrease in length of 1.3 cm (½ inch). At right, treatment for Peyronie’s disease using a traction device.]]