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 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 (55.8 degrees +/- 20 degrees vs 41.4 degrees +/- 20.8 degrees; 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. Copyright (C) 2019, The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine.