From the Guidelines
Treatment for turtle neck penis, also known as Peyronie's disease, should prioritize FDA-approved collagenase Clostridium histolyticum (Xiaflex) injections to break down scar tissue, while for phimosis, circumcision is the definitive surgical solution. For patients with Peyronie's disease, the use of collagenase Clostridium histolyticum injections has been shown to be effective in reducing penile curvature, as stated in the guidelines by the American Urological Association 1. In contrast, oral medications such as vitamin E, tamoxifen, procarbazine, omega-3 fatty acids, or a combination of vitamin E with L-carnitine are not recommended due to lack of convincing evidence for their efficacy 1. For patients with phimosis, gentle stretching exercises and topical steroid creams like betamethasone 0.05% can help increase skin elasticity, but if conservative measures fail, circumcision is the recommended solution, as suggested by various guidelines 1. It is essential for patients to consult a urologist for proper diagnosis and individualized treatment plans based on their specific symptoms and disease progression. Some key points to consider in the management of these conditions include:
- The importance of early treatment to prevent worsening of symptoms and impact on sexual function and urination
- The need for patients to have realistic expectations regarding the likely magnitude of treatment effects and the probability and type of adverse events
- The role of surgical options, such as plication procedures, plaque incision with grafting, or penile implants, for severe cases of Peyronie's disease
- The potential for circumcision to cure phimosis and the importance of follow-up care to monitor for disease recurrence or malignant change.
From the Research
Treatment Options for Turtle Neck Penis (Peyronie's Disease)
- Peyronie's disease is a progressive fibrotic disorder of the penis characterized by the formation of collagen plaques on the tunica albuginea, leading to penile deformity, pain, and erectile dysfunction 2.
- The treatment options for Peyronie's disease include oral therapies, intralesional injections, and penile traction therapy.
Oral Therapies
- Pentoxifylline has been shown to be effective in reducing penile curvature and plaque size in patients with Peyronie's disease 3, 4.
- Colchicine has also been used in combination with pentoxifylline and penile traction therapy to manage Peyronie's disease 5.
- A study found that the combination of pentoxifylline and colchicine with penile traction therapy resulted in a significant decrease in penile curvature and plaque size 5.
Intralesional Injections
- Verapamil injections have been used to treat Peyronie's disease, with studies showing significant improvement in penile curvature and plaque size 3, 6.
- A study compared the efficacy of verapamil and pentoxifylline in treating Peyronie's disease and found that combination therapy resulted in significant improvement in curvature reduction, plaque size reduction, and recovery rate of erectile dysfunction 3.
Penile Traction Therapy
- Penile traction therapy has been used in combination with oral therapies and intralesional injections to manage Peyronie's disease 6, 5.
- A study found that the use of penile traction therapy for more than 3 hours per day resulted in significant gain in stretched penile length 6.