Safety and efficacy of coenzyme Q10 supplementation in early chronic Peyronie's disease: a double-blind, placebo-controlled randomized study

Romano²,

et al. 2017

Advances in Urology

Peyronie's disease (PD) is a chronic inflammation of tunica albuginea of the corpora cavernosa that causes an inelastic plaque resulting in penis deformation. Although its etiology is not completely known, there is general consensus that PD is genetically transmitted and secondary to penile trauma. In recent years, numerous studies demonstrated the role played by oxidative stress in PD pathogenesis, and other studies have described successful use of antioxidants in PD treatment. Oxidative stress is an integral part of this disease, influencing its progression. In the early stages of PD, the inflammatory infiltrate cells produce high quantities of free radicals and proinflammatory and profibrotic cytokines, with consequent activation of transcription factor NF-κB. While conservative therapies commonly used in the early stages of PD include oral substances (Potaba, tamoxifen, colchicine, and vitamin E), intralesional treatment (verapamil, interferon, steroids, and more recently collagenase clostridium histolyticum-Xiaflex), and local physical treatment (iontophoresis, extracorporeal shock wave therapy, and penile extender), the significant results obtained by emerging treatments with the antioxidants cited in this article suggest these therapeutic agents interfere at several levels with the disease's pathogenetic mechanisms. Antioxidants therapy outcomes are interesting for good clinical practice and also confirm the fundamental role played by oxidative stress in PD.

Section: Discussionmentioning

confidence: 87%

Section: Pathophysiology Of Peyronie's' Disease (Figure 1)mentioning

confidence: 99%

Section: Pathophysiology Of Peyronie's' Disease (Figure 1)mentioning

confidence: 99%

See 1 more Smart Citation

Recent Pathophysiological Aspects of Peyronie’s Disease: Role of Free Radicals, Rationale, and Therapeutic Implications for Antioxidant Treatment—Literature Review

Romano²,

et al. 2017

Advances in Urology

“…83 Plaque size and penile curvature both decreased in the treatment group and slightly increased in the placebo group (both p=0.001). Additional studies are needed to confirm efficacy.…”

Section: Treatmentmentioning

confidence: 95%

Peyronie’s Disease: A Review of Etiology, Diagnosis, and Management

Bilgutay

Pastuszak

2015

Curr Sex Health Rep

Peyronie’s Disease (PD) is a superficial fibrosing disorder of the penis resulting in plaque formation and penile deformity. Once considered rare, PD has more recently been found in up to 13% of men, and can negatively affect sexual and psychosocial function of both patients and their partners. While the etiology of PD is unclear, it is thought to result from an inciting traumatic event followed by aberrant fibrosis or dysregulated wound healing. The evaluation of men presenting with PD includes a detailed history and physical exam, focusing on the penis in both the flaccid and erect states. PD is often associated with erectile dysfunction (ED), as well as several other comorbidities. Laboratory testing is not needed to diagnose PD, although given the associations between PD and systemic diseases including hypogonadism, diabetes, and cardiovascular disease, screening and work-up for these conditions in men with PD may be warranted. Treatment modalities for PD are diverse and include oral, topical, intralesional, mechanical, and surgical therapies. Oral, topical, and mechanical therapies generally have little evidence supporting their efficacy. Several intralesional therapies, including interferon α2b and collagenase Clostridium hystiolyticum have demonstrated efficacy in the treatment of PD. Surgical treatment, indicated in men with significant, stable deformity, includes plication of the tunica albuginea, plaque incision/excision and grafting, and placement of inflatable penile prosthesis (IPP) with or without additional maneuvers to achieve desired results, and has high success rates.

“…in the treatment of PD (Cavallini et al, 2002;Safarinejad, 2010b;Safarinejad et al, 2010a;Paulis et al, 2012). Verapamil reduces the proliferation of fibroblasts and the local production of extracellular matrix (by fibroblasts); it also increases the local activity of collagenase and it affects the cytokine regulation of fibroblasts reducing the excess production of fibrogenic cytokines (Taylor & Levine, 2008).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of vitamin E in the conservative treatment of Peyronie's disease: legend or reality? A controlled study of 70 cases

et al. 2012

SUMMARYThe medical treatment is indicated in the development stage of Peyronie's disease (PD) for at least 1 year after diagnosis and whenever in case of penile pain. This research was conducted to demonstrate the possible effectiveness of vitamin E in PD treatment, whereas in the scientific literature this topic is much discussed. A total of 70 patients (age:26-69 years, mean: 54.1 ± 9.71) diagnosed with PD were enrolled in a conservative treatment. In addition to medical histories and physical examinations all patients underwent the following tests: International Index of Erectile Function (IIEF) questionnaire, penile ultrasound and photographic documentation, pain evaluation by a conventional 10-point pain scale Visual analogue pain scale (VAS). All 70 patients were divided into two different treatment groups: A and B, with different combinations of drugs: A = vitamin E + verapamil (injection + iontophoresis) + blueberries + propolis + topical diclofenac; B = verapamil (injection + iontophoresis) + blueberries + propolis + topical diclofenac. All patients were treated for 6 months after which they underwent the same follow-up tests as performed prior to the treatment. Intergroup analysis revealed statistically significant differences: in the vitamin E group the effective plaque size reduction was À50.2% whereas in the control group the reduction was À35.8% (p = 0.027). In group A the improvement of curvature occurred in 96.6% of the cases whereas in the control group B this occurred in 48.4% (p = 0.0001), moreover, the mean curvature decrease was respectively À12.25°and À6.73°(p = 0.01). IIEF score was significantly improved in group A patients with comorbidities and erectile dysfunction (p = 0.025). Increase in plaque size occurred only in the control group (17.1%) (p = 0.032). We can affirm that vitamin E can help to prevent the progression of PD. This study strongly supports the recommendation that the best approach for treating PD is multimodal therapy.