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Commentary on “Phosphodiesterase type 5 inhibitors do not prevent curvature progression but shorten pain duration in the active phase of Peyronie’s disease: a retrospective cohort study”

International Journal of Impotence Research volume 36, pages 166–167 (2024)Cite this article

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In an article recently published in the International Journal of Impotence Research, Durukan et al. evaluated the impact on penile curvature and pain duration of Phosphodiesterase Type 5 Inhibitors (PDE5Is) administrated in the acute phase of Peyronie’s disease (PD) [1]. A total of 133 patients with acute PD were included in this single-center retrospective study. Group 1 (n = 101) received PDE5Is daily (n = 99: Sildenafil 25 mg; n = 2: Tadalafil 5 mg) while Group 2 (n = 32) did not receive any ED treatment. The mean ± standard deviation (SD) baseline penile curvature was 33.5 ± 16.6° in Group 1 and 32.2 ± 18.6° in Group 2 (p = 0.5). The mean ± SD time from onset of symptoms to first visit was 10.6 ± 7.2 and 11 ± 6.3 months in Group 1 and Group 2, respectively (p = 0.5). The mean ± SD duration of treatment of Group 1 was 10.9 ± 6.8 months. No significant difference was reported between the two groups in follow-up (11.3 ± 7 vs. 13.6 ± 7.1 months; p = 0.07). The mean change in penile curvature from the first to the final clinical visit was +0.87° (95% CI: −1.8, 3.5) in Group 1 and + 5.72° (95% CI: 1.4, 10) in Group 2 (p = 0.07). Overall, 31 (30.7%) patients in Group 1 and 15 (46.9%) in Group 2 experienced a worsening of the curvature (p = 0.09). Group 1 reported a mean ± SD pain duration of 9.1 ± 4.7 months, while Group 2 had a mean ± SD duration of pain for 12.2 ± 6.5 months (p = 0.04). The authors concluded that PDE5Is in acute PD can reduce the pain duration but does not appear to influence on curvature progression.

The main objectives of conservative therapy of acute phase of PD are pain relief and prevention of curvature progression. Achieving these goals helps preserve patients’ sexual function and quality of life (QoL). Furthermore, limiting penile curvature can facilitate the management of the chronic phase of the disease. Several non-operative treatments have been proposed to manage the pain and curvature progression in patients with acute PD. Currently, evidence supporting the role of some conservative therapies (e.g., nonsteroidal anti-inflammatory drugs, extracorporeal shock wave treatment) in pain relief is limited but sufficient for the formulation of specific recommendations in guidelines. On the contrary, evidence on conservative therapies to counteract the progression of penile curvature remains largely insufficient [2].

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Authors and Affiliations

  1. Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, 80131, Italy

    Celeste Manfredi

  2. Department of Urology, Rush University Medical Center, 60612, Chicago, IL, USA

    Celeste Manfredi, Eugenio Bologna & Leslie Claire Licari

  3. Unit of Urology, Department of Maternal-Child and Urological Sciences, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00185, Rome, Italy

    Eugenio Bologna & Leslie Claire Licari

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  1. Celeste Manfredi
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CM wrote the draft commentary. EB and LCL revised the grammar and chose the references. All authors approved the final version of the manuscript.

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Correspondence to Celeste Manfredi.

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Manfredi, C., Bologna, E. & Licari, L.C. Commentary on “Phosphodiesterase type 5 inhibitors do not prevent curvature progression but shorten pain duration in the active phase of Peyronie’s disease: a retrospective cohort study”. Int J Impot Res 36, 166–167 (2024). https://doi.org/10.1038/s41443-023-00811-4

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