Peyronie’s Disease is caused by the way a person’s body heals from trauma. The exact cause of Peyronie’s Disease is not understood. It is thought to be due to repeat microtrauma to the penile tunical tissues that surround the erectile cavernosal bodies in the penis. Tissue healing leads to inflammation with deposition of scar tissue and formation of calcified deposits within the penile tunical tissues. The inflammatory process itself can cause localised pain, which is typically worse with an erection. This pain is an indication of ongoing inflammation.

Peyronie’s plaques, unlike healthy penile tissue, have no elasticity and therefore cannot stretch when there is penile engorgement causing an erection. This can cause the penis to curve, indent or become shorter. Sometimes this can make it difficult or even impossible to have intercourse.

Peyronie’s Disease is not uncommonly associated with erectile dysfunction.  It is unclear exactly how they are related but there is likely an underlying process contributing to both. The natural history of the Disease is notable for an active and stable phase.  Curvature worsens in nearly half of all patients during the active phase and improves in <10–15% of patients. In contrast, pain improves or resolves in the majority of patients with time.

Acute Phase

• Usually resolves within 1 yr but can last over 18 months. This is when there is still active inflammation within the penis and plaques are forming.

Chronic Phase

• Usually start 12-18 months after the symptoms first appear
• During this period pain usually resolves or is significantly improved
• The plaques need to have stabilise along with penile angulation for at least 3-6 months to ensure that the acute phase has resolved
• Erectile dysfunction may still continue to worsen

Surgical incision of plaque and grafting

• This surgery is indicated for patients with angulation of >60° and intact erectile function
•  The neurovascular bundle is mobilised, the plaque is incised and a tissue graft (usually bovine) is placed to increase the length of penis at the site of the plaque
• This surgery helps restore penile length but comes with more risk, including a 20% risk of causing problematic long term erectile dysfunction.

Penile Prosthesis

• Approximately 30 % of patients presenting with Peyronie’s Disease have concomitant erectile dysfunction, and many of these patients do not respond to conservative medical therapy. Implantation of inflatable penile prosthesis has become the standard for patients with PD and erectile dysfunction.
• The insertion of the prosthesis may be adequate to improve curvature, with or without concomitant manual modelling (where fracturing of the plaque by hand is done while under anaesthetic in theatre).
• On occasion, the synchronous plication or incision +/- grafting procedure are required to provide satisfactory straightening at the time of prosthesis insertion.

In recent years, penile traction therapy has gained considerable interest as a novel nonsurgical treatment option for men with Peyronie’s disease. Studies have shown that penile traction therapy, when used appropriately, can give modest improvements in penile curvature and stretched penile length.

At Verve Men’s Clinic we commonly recommend the Restore X device. A study on this device showed that when used 1-3 times per day for 30 minutes over 3 months, mean curvature decreased by 18° and mean penile length increased by 1.5cm. More than 75% of patients showed improvement in curvature and 95% had an improvement in length.

The hardest part with this treatment is adherence to daily use for at least 30 minutes a day. The more the device is used the better the results are likely to be.

Platelet-Rich Plasmas Therapy with microneedling:

The potential benefits of treatment:

• The aims of treatment are to reduce pain, reduce penile curvature and improve sexual satisfaction.
• In general, best result are likely to be achieve if the treatment occurs early in the acute phase of Peyronie’s Disease, in patient with angulation <60 degrees.
• The other potential benefit of PRP Therapy is improved erectile function in >50%

Verapamil

• Verapamil is a calcium channel blocker drug that reduces fibroblast activity, which is responsible for scar tissue and plaque development.
• Verapamil injections have been shown to reduce penile pain and angulation, with results being variable across studies.
• Studies on verapamil alone have shown around 85% of men to have reduced pain and around 60% of men to have reduced penile angulation; with an average improvement of 4-17 degrees. However, when combined with microneedling and a penile traction device, even better results can be achieved.

Verapamil injections are considered safe but uncommon potential side effects related to the medication include temporary dizziness, weakness, nausea and sweating.

PRP

PRP therapy is generally considered safe, as it uses your own blood to create the platelet concentrate. However, as with any medical procedure, there are potential risks and complications, including infection, bleeding, pain, and swelling at the injection site.

Microneedling

Microneedling has been shown to be safe but has potential complications including – significant haematoma (blood clot) and swelling of the penis, penile fracture, urethral injury, blood in urine, infection and penile nerve or blood vessel injury; though no significant long term complications have been recorded.

Your initial consultation with the Urologist is $280 and follow-up appointments $140. These appointments attract a Medicare rebate with a valid Medicare card and referral.

Oral medications, erectile dysfunction advice and penile traction therapy information can be obtained at consultation phase.

If you wish to undertake Platelet-Rich Plasma (PRP) Therapy, with or without a microneedling technique, we offer these treatments at a cost of $1,750 for an initial treatment, and $1,225 for any subsequent treatments.

If you would like to pay for the recommended 4 treatments, you can pay up front to the cost of $4,900 to receive a discount of $525, equating each treatment to $1,225.

Medicare rebates are available for all PRP treatment sessions.

Low-intensity Shockwave Therapy (LiSWT) is recommended for 6 sessions across 3 weeks.

Each session costs $500, however this can be reduced to $400 if you pay for all 6 up front to the cost of $2,400.

Medicare rebates are available for all LiSWT treatment sessions.

Please contact our friendly reception staff for more information.

We do not offer payment plans on ICI treatments.

We may require that the full payment of the procedure is paid before your appointment.

Please contact our friendly reception staff for more information.

If you have a valid medicare card and referral, your initial consultation shall attract a medicare rebate. See our fees page for more information.

If valid, your rebate shall be processed at the time of your consultation and will be paid into your nominated bank account registered with Medicare.

Contact our friendly reception staff for more information.

We do not process private health claims, however you are welcome to check with your private health cover and claim directly with them.

Please contact our friendly reception staff, if you require consultation or procedure item numbers and/or receipts.

You may see Dr Philippe without a referral, however medicare rebates shall not apply and you will be liable to pay the full amount for every visit without any rebate.

Consider visiting your own GP to obtain a referral, or visit our GP Dr Jonny to obtain a referral.

If you already have a referral, please continue to book online, or by contacting our friendly reception staff to make an Initial Peyronie’s Disease Consultation.