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Evaluation of Oral Pentoxifylline, Colchicine, and Penile Traction for the Management of Peyronie’s Disease

INTRODUCTION: Currently, there are several treatment options for Peyronie disease (PD). Although surgical interventions have better reported outcomes than conservative therapy, surgery is not suitable for all patients with PD. Therefore, oral therapy for PD is still a frequently used treatment due t...

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Autores principales: Ibrahim, Ahmed, Gazzard, Lauren, Alharbi, Mohannad, Rompré-Brodeur, Alexis, Aube, Melanie, Carrier, Serge
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6963116/
https://www.ncbi.nlm.nih.gov/pubmed/31445974
http://dx.doi.org/10.1016/j.esxm.2019.07.003
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author Ibrahim, Ahmed
Gazzard, Lauren
Alharbi, Mohannad
Rompré-Brodeur, Alexis
Aube, Melanie
Carrier, Serge
author_facet Ibrahim, Ahmed
Gazzard, Lauren
Alharbi, Mohannad
Rompré-Brodeur, Alexis
Aube, Melanie
Carrier, Serge
author_sort Ibrahim, Ahmed
collection PubMed
description INTRODUCTION: Currently, there are several treatment options for Peyronie disease (PD). Although surgical interventions have better reported outcomes than conservative therapy, surgery is not suitable for all patients with PD. Therefore, oral therapy for PD is still a frequently used treatment due to low cost, convenience and limited side effects. However, current literature on the efficacy of oral therapy in PD is inconclusive. Pentoxifylline and colchicine have both shown some promise though further studies are required to confirm their effectiveness. AIM: The aim of this study was to assess the efficacy of oral therapy for PD, including pentoxifylline and colchicine, coupled with the Andropenis penile traction therapy (PTT) extender on degree of penile curvature and plaque size. METHODS: Between March 2015 and June 2018, a prospectively collected database for patients receiving oral therapy for PD (pentoxifylline and/or colchicine) was reviewed. MAIN OUTCOME MEASURE: Collected data variables were compared at baseline and after 6 months of treatment, including degree of curvature, plaque size, and penile Doppler ultrasound parameters (peak systolic velocity, minimum diastolic velocity, and pulsatility index). PTT was applied by the patient for a total of 1 hour per day for 6 months. RESULTS: A total of 46 patients were involved in this study. Mean age was 56 ± 10 years. There was a significant decrease in the degree of penile curvature after 6 months (55.8º ± 20º vs 41.4º ± 20.8º; P = .03). Likewise, the plaque size decreased significantly from 5.42 ± 2.7 to 2.42 ± 1.71 cm(2); P = .0001. There was a significant increase in the peak systolic velocity from 29.8 ± 10.02 to 38.2 ± 11cm/sec; P = .02, whereas no statistically significant difference could be detected regarding end diastolic velocity (M = 0.56 ± 3.1 vs 1.59; P = .415) or pulsatility index (M(diff) = 0.03; CI = -0.06 to 0.12; P = .473). Furthermore, there was no statistically significant difference in medication type of pentoxifylline or colchicine (M(diff) = 17.23; CI = -3.31 to 37.77; P = .09). CONCLUSION: Altogether, pentoxifylline and colchicine, taken with concomitant PTT, present a potentially convenient, low cost, and effective treatment for penile curvature and plaque resulting from PD. Prospective randomized trials are still required for better evaluation of the course of PD with patients undergoing conservative management. Ibrahim A, Gazzard L, Alharbi M, et al. Evaluation of Oral Pentoxifylline, Colchicine, and Penile Traction for the Management of Peyronie’s Disease. Sex Med 2019;7:459–463.
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spelling pubmed-69631162020-01-17 Evaluation of Oral Pentoxifylline, Colchicine, and Penile Traction for the Management of Peyronie’s Disease Ibrahim, Ahmed Gazzard, Lauren Alharbi, Mohannad Rompré-Brodeur, Alexis Aube, Melanie Carrier, Serge Sex Med Peyronie's Disease INTRODUCTION: Currently, there are several treatment options for Peyronie disease (PD). Although surgical interventions have better reported outcomes than conservative therapy, surgery is not suitable for all patients with PD. Therefore, oral therapy for PD is still a frequently used treatment due to low cost, convenience and limited side effects. However, current literature on the efficacy of oral therapy in PD is inconclusive. Pentoxifylline and colchicine have both shown some promise though further studies are required to confirm their effectiveness. AIM: The aim of this study was to assess the efficacy of oral therapy for PD, including pentoxifylline and colchicine, coupled with the Andropenis penile traction therapy (PTT) extender on degree of penile curvature and plaque size. METHODS: Between March 2015 and June 2018, a prospectively collected database for patients receiving oral therapy for PD (pentoxifylline and/or colchicine) was reviewed. MAIN OUTCOME MEASURE: Collected data variables were compared at baseline and after 6 months of treatment, including degree of curvature, plaque size, and penile Doppler ultrasound parameters (peak systolic velocity, minimum diastolic velocity, and pulsatility index). PTT was applied by the patient for a total of 1 hour per day for 6 months. RESULTS: A total of 46 patients were involved in this study. Mean age was 56 ± 10 years. There was a significant decrease in the degree of penile curvature after 6 months (55.8º ± 20º vs 41.4º ± 20.8º; P = .03). Likewise, the plaque size decreased significantly from 5.42 ± 2.7 to 2.42 ± 1.71 cm(2); P = .0001. There was a significant increase in the peak systolic velocity from 29.8 ± 10.02 to 38.2 ± 11cm/sec; P = .02, whereas no statistically significant difference could be detected regarding end diastolic velocity (M = 0.56 ± 3.1 vs 1.59; P = .415) or pulsatility index (M(diff) = 0.03; CI = -0.06 to 0.12; P = .473). Furthermore, there was no statistically significant difference in medication type of pentoxifylline or colchicine (M(diff) = 17.23; CI = -3.31 to 37.77; P = .09). CONCLUSION: Altogether, pentoxifylline and colchicine, taken with concomitant PTT, present a potentially convenient, low cost, and effective treatment for penile curvature and plaque resulting from PD. Prospective randomized trials are still required for better evaluation of the course of PD with patients undergoing conservative management. Ibrahim A, Gazzard L, Alharbi M, et al. Evaluation of Oral Pentoxifylline, Colchicine, and Penile Traction for the Management of Peyronie’s Disease. Sex Med 2019;7:459–463. Elsevier 2019-08-21 /pmc/articles/PMC6963116/ /pubmed/31445974 http://dx.doi.org/10.1016/j.esxm.2019.07.003 Text en © 2019 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Peyronie's Disease
Ibrahim, Ahmed
Gazzard, Lauren
Alharbi, Mohannad
Rompré-Brodeur, Alexis
Aube, Melanie
Carrier, Serge
Evaluation of Oral Pentoxifylline, Colchicine, and Penile Traction for the Management of Peyronie’s Disease
title Evaluation of Oral Pentoxifylline, Colchicine, and Penile Traction for the Management of Peyronie’s Disease
title_full Evaluation of Oral Pentoxifylline, Colchicine, and Penile Traction for the Management of Peyronie’s Disease
title_fullStr Evaluation of Oral Pentoxifylline, Colchicine, and Penile Traction for the Management of Peyronie’s Disease
title_full_unstemmed Evaluation of Oral Pentoxifylline, Colchicine, and Penile Traction for the Management of Peyronie’s Disease
title_short Evaluation of Oral Pentoxifylline, Colchicine, and Penile Traction for the Management of Peyronie’s Disease
title_sort evaluation of oral pentoxifylline, colchicine, and penile traction for the management of peyronie’s disease
topic Peyronie's Disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6963116/
https://www.ncbi.nlm.nih.gov/pubmed/31445974
http://dx.doi.org/10.1016/j.esxm.2019.07.003
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