Peyronie’s Disease: Current Medical Treatment and Future Perspectives

Purpose: Because of our incomplete understanding of the pathogenesis of Peyronie’s disease (PD), management of PD remains a therapeutic dilemma in the field of sexual medicine. Most currently available medical treatments have not demonstrated conclusive effects. The present review addresses the current status of nonsurgical treatment and emerging new therapeutic targets for PD. Materials and Methods: A systematic review of clinical or preclinical results of nonsurgical treatment for PD published as original articles in peer-reviewed journals is provided. Results: Although many studies regarding nonsurgical treatment of PD showed positive outcomes, the majority of these studies were not placebo-controlled approaches. Currently available randomized controlled trials on the use of oral, intralesional injection, and topical agents have not showed conclusive effects, with minor or little effect. However, the outcomes of recent preclinical studies targeting the TGF-β pathway or NO-cGMP pathway are promising. Conclusions: There is no viable therapeutic option for PD between watchful waiting and surgical manipulation. With further research into the pathologic cascade of cellular and molecular events and an increase in our understanding of the pathophysiology of PD using animal models, the development of novel and effective medical therapies will become a realistic objective. (Korean J Urol 2009;50:527-533) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏