Effects of long term sildenafil on the acute phase of Peyronie’s disease in a combination treatment


Published: September 26, 2022
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Authors

  • Murat Topcuoglu Department of Urology, Alaaddin Keykubat University Alanya Training and Research Hospital, Antalya, Turkey.
  • Murat Çakan Department of Urology, Dıs¸kapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.

Objectives: The aim of this study was to investigate the impact of the addition of 50 mg daily sildenafil to pentoxifylline-colchicine combination ther-apy on the Peyronie's plaque features in patients with the acute phase of Peyronie's disease (PD).
Methods: In this retrospective and non-randomized clinical study, patients were divided into 2 groups as group 1; (n = 107) who received colchicine and pentoxyfillin plus 50 mg daily oral sildenafil, and as group 2; (n = 79) who received only colchicine and pentoxyfillin. Patients were compared in terms of degree of curvature, pain in erection and erectile function at the baseline and at 6-month follow up. Pain in erection and erectile func-tion were evaluated by visual Analogue Scale (EF-VAS), and the shortened version of the International Index of Erectile Function (IIEF-5). Improvement in the degree of curvature and change in EF-VAS scores were primary endpoints of the study. Change in IIEF-5 score was the secondary endpoint of the study.
Results: The two groups were statistically similar in terms of demographics and baseline features of PD. A statistically signifi-cant reduction in degree of curvature and EF-VAS scores was shown in group 1 compared to group 2.There was also a signifi-cantly higher IIEF-5 score in group 1 compared to group 2. No significant side effects were detected in both groups during treatment period.
Conclusions: Adding sildenafil to pentoxifylline-colchicine com-bination treatment seems to improve PD related symptoms in the acute phase PD. PDE5i may contribute to relieve the Peyronie's symptoms in ED patients through their antifibrotic effects.


Tunuguntla. HS. Management of Peyronie's disease a review. World J Urol. 2001; 19:244-250. DOI: https://doi.org/10.1007/s003450100209

Kadioglu A, Tefekli A, Erol B, et al. Retrospective review of 307 men with Peyronie’s disease. J Urol. 2002; 168:1075. DOI: https://doi.org/10.1016/S0022-5347(05)64578-8

Schwarzer U, Sommer F, Klotz T, et al. The prevalence of Peyronie's disease: results of a large survey. BJU Int. 2001; 88:727-30. DOI: https://doi.org/10.1046/j.1464-4096.2001.02436.x

Bilgutay AN, Pastuszak AW. Peyronıe's disease: a review of etiol-ogy, diagnosis, and management. Curr Sex Health Rep. 2015; 7:117-131. DOI: https://doi.org/10.1007/s11930-015-0045-y

Chung E, Ralph D, Kadioglu A, et al. Evidence-based management guidelines on Peyronie's disease. J Sex Med. 2016; 13:905-923. DOI: https://doi.org/10.1016/j.jsxm.2016.04.062

Ferrini MG, Davila H, Kovanecz I, et al. Long-term continuous treatment with vardenafil prevents fibrosis and preserves smooth muscle content in the rat corpora cavernosa after bilateral cavernos-al nerve transection. Urology. 2006; 68:429-435. DOI: https://doi.org/10.1016/j.urology.2006.05.011

Ilg MM, Mateus M, Stebbeds WJ, et al. Anti-fibrotic synergy between phosphodiesterase type 5 inhibitors and selective oestrogen receptor modulators in Peyronie’s disease models. Eur Urol. 2019; 75:329-340. DOI: https://doi.org/10.1016/j.eururo.2018.10.014

Kadiog˘lu A, Tefekli A, Erol H, et al. Color Doppler ultrasound assessment of penile vascular system in men with Peyronie's disease. Int J Impot Res. 2000; 12:263-7 DOI: https://doi.org/10.1038/sj.ijir.3900569

Vande Berg JS, Devine CJ, Horton CE, et al. Mechanisms of calci-fication in Peyronie's disease. J Urol. 1982; 127:52-54. DOI: https://doi.org/10.1016/S0022-5347(17)53599-5

Ibrahim A, Gazzard L, Alharbi M, et al. Evaluation of oral pen-toxifylline, colchicine, and penile traction for the management of Peyronie’s disease. Sex Med. 2019; 7:459-63. DOI: https://doi.org/10.1016/j.esxm.2019.07.003

Hellstrom WJ, Bivalacqua TJ. Peyronie's disease: etiology, med-ical, and surgical therapy. J Androl 2000; 21:347-354.

Hatzimouratidis K, Eardley I, Giuliano F, et al. EAU Guidelines on penile curvature. Eur Urol. 2012; 62:543-52. DOI: https://doi.org/10.1016/j.eururo.2012.05.040

Nehra A, Alterowitz R, Culkin DJ, et al. Peyronie’s disease: AUA Guideline. J Urol. 2015; 194:745-753. DOI: https://doi.org/10.1016/j.juro.2015.05.098

Chiao TB, Lee AJ. RoLe of pentoxifylline and vitamin E in atten-uation of radiation-induced fibrosis. Ann Pharmacother. 2005; 39:516-522. DOI: https://doi.org/10.1345/aph.1E186

Safarinejad MR, Asgari MA, Hosseini SY, Farid D. A double-blind placebo-controlled study of the efficacy and safety of pentoxifylline in early chronic Peyronie’s disease. BJU Int. 2009; 106:240-248. DOI: https://doi.org/10.1111/j.1464-410X.2009.09041.x

Alizadeh M, Karimi F, Fallah MR. Evaluation of verapamil efficacy in Peyronie's disease comparing with pentoxifylline. Glob J Health Sci. 2014; 6(7 Spec No):23-30. DOI: https://doi.org/10.5539/gjhs.v6n7p23

Brant WO, Dean RC, Lue TF. Treatment of Peyronie's disease with oral pentoxifylline. Nat Clin Pract Urol. 2006; 3:111-5. DOI: https://doi.org/10.1038/ncpuro0409

Prieto Castro RM, Leva Vallejo ME, Regueiro Lopez JC, et al. Combined treatment with vitamin E and colchicine in the early stages of Peyronie's disease. BJU Int. 2003; 91:522-4. DOI: https://doi.org/10.1046/j.1464-410X.2003.04134.x

Akkus E, Breza J, Carrier S, et al. Is colchicine effective in Peyronie’s disease? A pilot study. Urology. 1994; 44:291-295. DOI: https://doi.org/10.1016/S0090-4295(94)80155-X

Vernet D, Magee T, Qian A, et al. Phosphodiesterase type 5 is not upregulated by tadalafil in cultures of human penile cells. J Sex Med. 2006; 3:84-94. DOI: https://doi.org/10.1111/j.1743-6109.2005.00197.x

El-Sakka AI, Hassoba HM, Pillarisetty RJ, et al. Peyronie’s dis-ease is associated with an increase in transforming growth factor-beta protein expression. J Urol. 1997; 158:1391-1394. DOI: https://doi.org/10.1016/S0022-5347(01)64223-X

Dunkern TR, Feurstein D, Rossi GA, et al. Inhibition of TGF-b induced lung fibroblast to myofibroblast conversion by phosphodi-esterase inhibiting drugs and activators of soluble guanylyl cyclase. Eur J Pharmacol. 2007; 572:12-22. DOI: https://doi.org/10.1016/j.ejphar.2007.06.036

Wang-Rosenke Y, Neumayer HH, Peters H. NO signaling through cGMP in renal tissue fibrosis and beyond: key pathway and novel therapeutic target. Curr Med Chem. 2008; 15:1396-1406. DOI: https://doi.org/10.2174/092986708784567725

Valente EG, Vernet D, Ferrini MG, et al. L-arginine and phos-phodiesterase (PDE) inhibitors counteract fibrosis in the Peyronie's fibrotic plaque and related fibroblast cultures. Nitric Oxide. 2003; 9:229-44. DOI: https://doi.org/10.1016/j.niox.2003.12.002

Gholami SS, Gonzalez-Cadavid NF, Lin CS, et al. Peyronie’s dis-ease: a review. J Urol. 2003; 169:1234. DOI: https://doi.org/10.1097/01.ju.0000053800.62741.fe

Cakan M, Akman T, Oktar T, et al. The clinical characteristics of Peyronie's patients with notching deformity. J Sex Med. 2007; 4:1174-1178. DOI: https://doi.org/10.1111/j.1743-6109.2006.00258.x

Chung E, Deyoung L, Brock GB. The role of PDE5 inhibitors in penile septal scar modeling: assessment of clinical and radiological outcomes. J Sex Med. 2011; 8:1472-7. DOI: https://doi.org/10.1111/j.1743-6109.2011.02217.x

Ozturk U, Yesil S, Goktug HN, et al. Effects of sildenafil treat-ment on patients with Peyronie's disease and erectile dysfunction. Ir J Med Sci. 2014; 183:449-53. DOI: https://doi.org/10.1007/s11845-013-1036-5

Palmieri A, Imbimbo C, Creta M, et al. Tadalafil once daily and extracorporeal shock wave therapy in the management of patients with Peyronie’s disease and erectile dysfunction: results from a prospective randomized trial. Int J Androl. 2012; 35:190-195. DOI: https://doi.org/10.1111/j.1365-2605.2011.01226.x

Levine LA, Greenfield JM. Establishing a standardized evaluation of the man with Peyronie’s disease. Int J Impot Res. 2003; 15:S103-S112. DOI: https://doi.org/10.1038/sj.ijir.3901083

Murat Çakan, Department of Urology, Dıs¸kapı Yıldırım Beyazıt Training and Research Hospital, Ankara

0000-0002-6220-5509 orcid number

Topcuoglu, M., & Çakan, M. (2022). Effects of long term sildenafil on the acute phase of Peyronie’s disease in a combination treatment. Archivio Italiano Di Urologia E Andrologia, 94(3), 319–322. https://doi.org/10.4081/aiua.2022.3.319

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