Surgery
Surgery such as the "Nesbit operation", which is named after Reed M. Nesbit (1898–1979), an American urologist at University of Michigan), is considered a last resort and should only be performed by highly skilled urological surgeons knowledgeable in specialized corrective surgical techniques. A penile implant may be appropriate in advanced cases. Epidemiology
It is estimated to affect between .4 to 20% of men. The condition becomes more common with age. The mean age at onset of disease is 55–60 years although many cases have been recorded in adolescence and early 20’s.The overall prevalence of PD is about .4 to 20 percent in men. Rates range from 3.2 percent in a community-based survey of 4432 men (mean age of sample 57.4) to 16 percent among 488 men undergoing evaluation for erectile dysfunction (mean age 52.8). The prevalence of PD among the 4432 men in the community based study who responded by self report positively for palpable plaque, newly occurring angulation or curvature and painful erection was 1.5 percent between the ages of 30 and 39, 3 percent between 40 and 49, 3 percent between 50 and 59, 4 percent between 60 and 69, and 6.5 percent over 70. In 534 men undergoing routine prostate screening for cancer detection (without a specific urologic complaint), the prevalence of PD was 8.9 percent. In this study, the mean age of those with PD was 68.2 years compared with 61.8 years of those without PD.
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.