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Objectives: To evaluate the effects of upregulators of nitric oxide in one patient with Peyronie’s disease, after non significant improvement following intracavernosal verapamil. Methods: A 20-years-old Caucasian male presented with penile induration in flaccid state, persistent during erection and associated with mild pain at third middle of penis. After treatment with intracavernosal verapamil for 4 months with relief of penile discomfort, followed by counseling on the use of penile extender for at least 6 hours per day, he was prescribed pentoxifylline associated with tadalafil plus levo-arginine, propionil-carnitine and Vitamin B3. Results: After almost 2 years, the septal thickness was reduced at ultrasound evaluation after this “triple oxygenant therapy”. Conclusion: NO-iNOS biology in Peyronie patients is the very protagonist in modulating penile fibrosis through up-regulation of NO-cGMP pathway that influences penile health by preventing and reversing fibrosis in the tunical albuginea.
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