Table of contents
Peyronie's disease
Guidelines
Key sources
The following summarized guidelines for the evaluation and management of Peyronie's disease are prepared by our editorial team based on guidelines from the European Association of Urology (EAU 2024), the European Society for Sexual Medicine (ESSM 2022), and the American Urological Association (AUA 2015).
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Diagnostic investigations
History and physical examination: as per EAU 2024 guidelines, elicit a medical and sexual history in patients with Peyronie's disease, including duration of the disease, pain on erection, penile deformity, difficulty in vaginal/anal intromission due to disabling deformity, and erectile dysfunction.
A
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Diagnostic imaging
Diagnostic procedures
Medical management
Management of pain: as per EAU 2024 guidelines, consider offering NSAIDs
B
and extracorporeal shockwave therapy for the treatment of penile pain in the acute phase of Peyronie's disease. C
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Management of erectile dysfunction
Agents with no evidence for benefit
Therapeutic procedures
Indications for conservative treatment: as per EAU 2024 guidelines, offer conservative treatment in patients not fit for surgery or when surgery is not acceptable to the patient.
A
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Intralesional injections (collagenase clostridium histolyticum)
Intralesional injections (interferon alpha-2b)
Intralesional injections (verapamil)
Intralesional injections (corticosteroids)
Intralesional injections (platelet-rich plasma and hyaluronic acid)
Electromotive drug administration
Penile traction and vacuum devices
Extracorporeal shock wave therapy
Radiotherapy
Surgical interventions
Surgical reconstruction: as per EAU 2024 guidelines, perform surgery only when Peyronie's disease has been stable for at least 3 months (without pain or deformity deterioration), usually after 12 months from the onset of symptoms, and intercourse is compromised due to deformity.
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Penile prosthesis