Peyronie’s Disease

Minerva Urol Nefrol. 1995 Mar;47(1):25-9.

Laser and ultrasonic therapy in simultaneous emission for the treatment of plastic penile induration.

[Article in Italian]

Felipetto R, Vigano L, Pagni GL, Minervini R.

Clinica Urologica, Universita degli Studi di Pisa.

Induratio penis plastica (IPP) or Peyronie’s Disease is characterized by the presence of one or more fibrous patches in the tunica albuginea or intercavernous septum. IPP is a slowly evolving disease which may cause a bending of the penis as well as pain during erection. As an alternative to the numerous pharmacological therapies already existing, or in association with them, some kinds of physical treatments, such as ionophoresis, ultrasound therapy and laser therapy, have recently been used. In this study we have evaluated the effectiveness of physical therapy combined with laser and Ultrasounds in the treatment of IPP. Sixty-eight patients were randomly divided into three groups: the first group was treated with orgotein infiltrations, the second with laser and Ultrasounds and the third with an association of both treatments. On the basis of this study, we can affirm that the effectiveness of laser therapy associated with ultrasounds in treating painful symptomatology of IPP at its initial phase overlaps that of orgotein infiltrations. No measurable modifications were documented neither in patch dimensions nor in their echostructures and in no case remarkable modifications of the penile bending were evidenced. Therefore laser therapy associated with ultrasounds represents at the moment an efficacious alternative to medical treatment of IPP at the initial phase, as it does not present any kind of contraindications and it is surely better tolerated than any treatment with penile infiltrations.

NON-INVASIVE LASER THERAPY OF MORBUS PEYRONIE – INDURATIO PENIS PLASTICA

Miroslav Prochazka, M. D., Karel Koci, M. D. Rehabilitation Clinic Jarov, Prague; Andrology Clinic Andromeda, Prague, Czech Republic

Induratio penis plastica is a rare affection of male penis though occurrence is reported in 6 – 9 per cent of male population. From clinical, as well as from theoretical point of view this is very interesting kind of proliferous inflammation. Thus dual mechanism of effect of non-invasive laser beam can be employed in implicating overproduction of fibrin (and its resorption) as well as in direct influence upon inflammatory processes.

In our study 40 patients have been followed for more than a five-year period. We combine classical medicamentous techniques (colchicine, E vitamin) together with non-invasive laser of the following parameters: probes 200 and 300 mW, 50 J/cm2 continuous mode + 50 J/cm2 with beam modulated in 5 Hz frequency in one therapy bout. The therapy is applied 20 times in a row, twice a week as introductory series of procedures, followed by, according to clinical results, maintenance series of 3 – 5 procedures 2 – 3 times a year. Furthermore, we have found useful a combination with one more kind of physiotherapy – ultrasound – presumably due to erosion of syndesmotic conjunctions.

Results:

– 100 per cent of patients without painfull erection (mostly from second or third procedure on, as it is usually for the pain that patients are stirred to see a doctor, not for the deformity),

– 60 per cent of patients with significant reduction, or even fade of palpable resistance,
– less than 30 per cent of patients with marked effect on deformity of penis in the course of erection. Lesser effect on deformity during erection can be noticed with patients whose palpable resistance fade away completely. Theoretically, we are of the opinion that it is a result of permanent conversion of syndesmotic stroma of cavernous corpora, persisting even after disposal of overproducted fibrin. In general, better prognosis can be expected with patients with a clear causer of the affection (trauma, catheterization) than with idiopathic forms, or even with forms connected with other and overall affections (combination with Dupuytren´s contractures)

Conclusions:

We consider therapy with non-invasive laser to be absolutely the most effective component of the whole therapeutical complement within the scale of possible therapies of Morbus Peyronie (Induratio Penis Plastica), and therefore we establish it a routine method for all patients suffering from this affection. Its main contribution is high clinical efficacy, with negligible possible rate of theoretical risks (we have not observed any side effects of this therapy), and unique compliance of a method which is not connected with any unpleasant feelings for the patient.

Khirurgiia (Sofiia). 1989;42(4):30-1.

A new method for treating Peyronie’s disease.

[Article in Bulgarian]

Mazo VE.

Results are reported of the treatment of Peyronie’s disease by a laser-magnetic method. The “Ulamag” apparatus used is Soviet produce, based on helium-neon laser. For the period 1981-1988 a total of 713 patients have been treated. The method of treatment is described. The results were excellent in 114 patients (16 per cent), good in 535 (75 per cent) and satisfactory in 64 (9 per cent). Best results–complete cure–were obtained in patients in initial stage of the disease. In all others there occurred significant decrease in fibrous plaques size, softening and elasticity and disappearance of pain. All this helped to resume normal sexual life.