Nonsurgical interventions for peyronie disease: 2011 update

Peyronie disease (PD) arises from the deposition of collagen and fibrin that creates a plaque in the tunica albuginea of the penis. The resulting induration and curvature of the penis leads to sexual dysfunction in many men. Despite the prevalence of the disease and natural history studies that suggest progression, men might not seek therapeutic intervention due to a lack of general knowledge about the disease, its pathophysiology, and treatments aimed at ameliorating its symptoms. Medical therapy using oral, topical, or intralesionally delivered drug is pursued in all but the most severe cases. This review of the literature in the last 4 years attempts to identify new trials of therapies and treatment modalities aimed at altering the PD process. Specifically, we will address clinical trials evaluating oral pharmacotherapies; topical, intralesional, and shockwave therapies; and penile traction devices. We will discuss the level of evidence and support for each of the new clinical trials.