Can pentoxifylline be used for the treatment of Peyronie's disease?

Pentoxifylline for Peyronie's Disease Treatment

Pentoxifylline should not be used for the treatment of Peyronie's disease due to lack of proven efficacy, according to current guidelines. 1

Evidence Against Pentoxifylline Use

• The European Association of Urology (EAU) 2025 guidelines explicitly state that oral treatments including pentoxifylline are not recommended for Peyronie's disease due to a lack of proven efficacy 1
• These ineffective oral treatments may delay more effective interventions for patients 1
• The American Urological Association (AUA) guidelines similarly recommend against oral therapies without proven efficacy for Peyronie's disease 1

Current Recommended Approaches for Peyronie's Disease

For Active Disease Phase (pain, progressive deformity)

• NSAIDs may be offered for pain management in the active phase of Peyronie's disease 1
• Daily tadalafil 5 mg has demonstrated lower curvature progression rates and improved symptoms versus controls 1

For Stable Disease Phase

• Intralesional collagenase of Clostridium histolyticum (CCH) is recommended for patients with stable disease, penile curvature between 30° and 90°, and intact erectile function 1, 2
• Low-intensity extracorporeal shockwave therapy (LI-ESWT) may be offered for penile pain relief but not for curvature reduction or plaque size reduction 1
• Penile traction therapy (PTT) works through collagen remodeling but requires extended daily use (2-8 hours) 1

Research on Pentoxifylline

Despite the guideline recommendations against pentoxifylline use, some research has explored its potential:

• A 2019 study suggested that pentoxifylline combined with penile traction therapy might decrease penile curvature and plaque size, but this study lacked a control group for pentoxifylline alone 3
• A 2014 comparative study between verapamil and pentoxifylline showed no significant difference between the two treatments, but suggested combination therapy might be more effective 4
• A 2016 case-control study reported some benefit with pentoxifylline in combination with other antioxidants, but this approach is not endorsed by current guidelines 5

Important Considerations

• Treatment decisions should prioritize evidence-based approaches with proven efficacy 1
• Patients should be reassured that Peyronie's disease does not lead to any form of malignancy 1
• For patients with erectile dysfunction and Peyronie's disease, the erectile dysfunction should be treated first or concomitantly 1
• Surgical options should only be considered after the disease has been stable for 3-6 months 6

Common Pitfalls to Avoid

• Delaying effective treatments by pursuing unproven oral therapies like pentoxifylline 1
• Failing to distinguish between active and stable disease phases, which require different management approaches 1
• Not considering the impact of Peyronie's disease on erectile function and quality of life when selecting treatments 1, 2
• Expecting complete resolution of penile curvature with non-surgical treatments, as most provide only modest improvements 2

In conclusion, current guidelines from both European and American urological associations do not support the use of pentoxifylline for Peyronie's disease treatment due to lack of proven efficacy.