Peyronie’s disease

Summary: Urological referral not normally indicated

Advice: Referral for Peyronie’s disease is now actively discouraged unless the deformity prevents penetration, the disease prevents erection and the condition has been stable for at least 6 months
Refer To: Any adult urologist

Contents:

Clinical information

There is no effective medical treatment except in the early (painful) stages where Tamoxifen 20mg BD, taken for 6 weeks, may be helpful.

If erections are impaired, Vitamin E may improve the situation but the natural history is one of spontaneous resolution (in 60-70% of patients) and surgery will not normally be considered as a first-line treatment.

Surgical intervention is only indicated if the penis is too bent for penetration (when the penis should be straightened by a Nesbit’s or Lue procedure) or if the disease prevents distal tumescence (when implantation of penile prostheses may be needed). No surgical intervention will be considered, however, until the disease has been stable for at least 6 months.

For other casuses of erectile deformity, go to the erectile deformity guidelines.

Please note: Implantation of penile prostheses is NOT available at Addenbrooke’s and suitable patients will need to be referred to the Institute of Urology in London or to the Norfolk & Norwich Hospital.

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Special information

This page contains guidelines and advice from professional bodies, together with information about the prescription of drugs. Since all NHS hospitals have local arrangements with their Primary Care Trusts (PCTs) about which medicines can be used, some drugs mentioned cannot be prescribed by local hospitals.

Treatment of patients will be planned with the Consultant responsible for care, taking into account those drugs which are or are not available at the local hospital and what is appropriate for optimum patient care.

Healthcare professionals are advised to check prescribing arrangements with their local hospital or PCT.

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