Ultrasound is useful for the identification of lesions and to determine their relationship with the neurovascular bundle. Individuals with Peyronies disease can present with erectile dysfunction, often related to venous leakage, due to insufficient drainage at the site of the plaque. Although plaques are more common on the dorsum of the penis, they can also be seen on the ventral face, lateral face, or septum. Treatment
Medication and supplements
Many oral treatments have been studied but results so far have been mixed. Some consider the use of nonsurgical approaches to be controversial.Vitamin E supplementation has been studied for decades, and some success has been reported in older trials; those successes have not been reliably repeated in larger, newer studies. The use of Interferon-alpha-2b in the early stages of the disease has been studied; as of 2007, its efficacy was questionable.Collagenase clostridium histolyticum is reported to help by breaking down the excess collagen in the penis. It was approved for treatment of Peyronies disease by the FDA in 2013. Physical therapy and devices
There is moderate evidence that penile traction therapy is a well-tolerated, minimally invasive treatment; there is uncertainty about the optimal duration of stretching per day and per course of treatment, and the treatment course is difficult. Focused shockwave therapy
Focused extracorporeal shockwave therapy is a non-invasive treatment option that involves passing acoustic pulses through the plaque, which can break it down over a series of six to twelve sessions. The treatment is most effective in men with mild to moderate Peyronies.
Progesterone vaginal ring, also known as progesterone-only vaginal ring, is a form of vaginal ring used for birth control when breastfeeding. Use can begin at four weeks and continue for at least up to a year following childbirth. Failure rates with usual use is about 1.5 per 100 women. It is used within the vagina with one ring lasting three months. The woman is able to place and remove the ring herself. It is sold under the brand names Progering among others.Side effects include vaginal discharge and pain with urination. It does not appear to be associated with serious side effects. With use menstrual periods often do not resume. It was specifically made for use with breastfeeding as it does not affect milk production. It works by gradually releasing the hormone progesterone.Progesterone vaginal rings have been approved for medical use since 1998. It is on the World Health Organizations List of Essential Medicines. As of 2014, they are available in a number of South and Central American countries. As of 2016, it is not available in the United States. It was developed by the Population Council. See also
Pharmacokinetics of progesterone § Vaginal administration


== References ==