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Peyronie’s Disease, Ancient and Complex

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Peyronie’s disease is a very ancient and complex disease, first described in 1743 by François Gigot de La Peyronie, a French surgeon who was the personal physician of King Louis XV.

De La Peyronie published a detailed report on this condition, describing the symptoms and their impact on male sexual function. Although the disease bears his name, it is likely to have existed long before being formally identified and documented. It is a condition that causes the development of fibrous scar tissue in the penis, related to trauma or microtrauma of the penis, often unnoticed, its prevalence, varies according to the studies and the populations analyzed.

Doctor Ramiro Fragas Valdés.

It is estimated to affect approximately 0.5% to 13% of men worldwide. The variability in these figures may be due to differences in diagnostic methods, the population studied, and the age of the individuals evaluated, since the prevalence tends to be higher in men over 50 years of age.

The clinical picture may vary, the main symptom is deformity of the erect penis, which varies from tilting upwards, downwards to the right or left, depending on the location of the site of scar fibrosis, it deviates to the side contrary.

There may be shortening or retraction of the penis, when fibrosis infiltrates the septum that divides both corpora cavernosa; the deformity may be “hourglass” shaped, when the scar is circular. There may also be pain during erection, especially in the initial phase of the disease, being a good time to start anti-inflammatory treatment with drugs and physical therapy (ultrasound and therapeutic laser), intralesional therapy with medications such as: Verapamil, Interferon, Steroids, platelet-rich plasma, etc., continues to be practiced by some Urologists in the world, with the hope that the patient can improve the pain, “accelerate the plaque maturation process”, other times, by offering the patient “ distressed”, upon seeing the deformity of his penis, “some medicinal treatment”, but there is no curative treatment in the world that improves all patients with Peyronie’s disease, however, from an ethical point of view, it is not a Good Clinical Practice Intralesional Therapy, because it could negatively interfere with the natural evolution of your disease due to the trauma of the needle and/or the medication, without having obvious or real effectiveness.

 Try to use some of the Propolis Formulations based on the Research (published in Arch Españoles de Urología and in the International Journal of Andrology) of Professor and DrC Manuel Lemourt Oliva, where he demonstrated the clinical and immunological improvement of patients with PD using doses 300 – 900 mg on an empty stomach for 6 -12 months or more.

We must keep in mind that approximately 60% of patients with small plaques and mild or moderate symptoms experience spontaneous improvement or stability, without having done anything, while others with extensive, painful plaques experience deformity and shortening, with or without erectile dysfunction, almost always venom-occlusive since the fibrous plaque infiltrates the subalbuginea, affecting the closure of the emissary veins, responsible for blood remaining inside the penis, during sexual arousal. Many of these cases would be candidates for Corrective Surgery of the deformity, if the disease is stable with more than 1 year of evolution. While others with a more disabling disease should go directly to penile prostheses that correct the deformity, the progressive shortening of the penis and resolve Erectile Dysfunction, the results of this behavior in our experience and what has been reviewed in the literature is effective. and satisfactory in more than 94% of patients.

I agree with this behavior, but, particularly in the initial inflammatory phase with painful plaques, I recommend using an anti-inflammatory cream (Benzydamine, Diclofenac, Ibuprofen, etc.). Dexamethasone 0.75 mg daily for 20 days, rest for 10 days and another similar cycle. If it is possible to use physical therapy with soft laser, therapeutic ultrasound or low-intensity shock waves, the pain and elasticity of the plaque should improve.

Although, both Professor Lemourt and I think that a higher dose of the product and used for a longer time (24 months or more) could offer better results (this is our hypothesis). Look at some of the Formulations on the market. I hope that researchers who see patients with Peyronie’s Disease join forces with manufacturers of Propolis Formulations to continue investigating the usefulness of this product in PD, which because it is cheap, easy to administer (orally) with few or no side effects, if we can demonstrating its effectiveness in Peyronie’s disease, it would be the only product in the world, with these characteristics, which could provide a solution or improvement to a very old disease, described for the first time in 1743 by François Gigot de La Peyronie.

De La Peyronie published a detailed report on this condition, describing the symptoms and their impact on male sexual function. Although the disease is named after him, it is likely that it existed long before being formally identified and documented.”

Doctor Ramiro Fraga Valdés.

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