Peyronie’s illness is characterized by the development of fibrotic plaques within the tunica albuginea. The prevalence of the condition has been estimated to be between 3percent and 9percent. The natural history of Peyronie’s illness is controversial with some studies suggesting that 50percent of patients showing some degree of resolution or improvement while othernesss claim that only 13percent of patients report improvement. The etiology of the condition is equally controversial. The most widely accepted theory is that an injury to the penis, causing a buckling or tearing of the tunica albuginea, results in the disruption of blood vessels, leading to an inflammatory response with subsequent remodeling of the connective tissue into fibrosis.

The great number and variety of purported pharmacomedical cares for Peyronie’s illness is in proportion to the difficulty of its management. A recent case report by W. O. Brant and Tom Lue from the University of California, San Francisco, examines the use of a novel oral agent, pentoxifylline, for the pharmacomedical care of the pain and curvature associated with Peyronie’s illness. The report is published in the February Buy viagra 60 pills on new AmPills.com store issue of Nature medical institution al Practice Urology.

Pentoxifylline, or Trental, has been used in humans (in divided doses of 800-1600 mg per day) in a variety of inflammatory and fibrotic conditions, including radiation fibrosis, radiation proctitis, cystic fibrosis, radiation pneumonitis and steatohepatitis. The mechanism is not fully understood; pentoxifylline blocks the transforming growth factor (TGF) B1- mediated pathway of inflammation, prevents deposition of collagen type 1, and acts as a nonspecific phosphodiesterase (PDE) inhibitor.

In the case report, a 51-year-old male presented with the chief complaint of a penile mass, which had been present for 8 months. The mass appeared rapidly over a 3 month period and then stabilized. The patient denied pain but had a 30 degree dorsolateral curvature which inhibited sexual intercourse. The patient also had an hourglass deformity of his penis on exam. Erections were less firm than previously but did respond to health/health/viagra/”>health/viagra-soft-tabs/”>viagra soft tabs/”>health/viagra/”>health/viagra-soft-tabs/”>viagra soft tabs (health/viagra-soft-tabs/”>viagra soft tabs citrate) . Ultrasonography was performed, revealing two calcified areas in the tunica albuginea of the left corpus cavernosum, one dorsal and one ventral. The patient was prescribed pentoxifylline 400 mg three times a day and took the medication for 6 months. Upon re-evaluation at 6 months, his penis had straightened to 10 degrees of curvature, but still demonstrated an hourglass deformity. After two years of pentoxifylline medical care, improved erectile function was reported without the use of erectogenic agents. Ultrasonography and physical exam showed resolution of the dorsal plaque although the ventral plaque was still present.

The authors, encouraged by pentoxifylline’s observed suppression of collagen production in Peyronie’s cells in tissue culture, as well as its efficacy in otherness fibrotic disorders, have been offering patients’ pharmacomedical care with pentoxifylline for Peyronie’s illness since 2002. A series of 16 patients with extended follow-up will soon be part of a new report to further describe the efficacy of this drug in the pharmacomedical care of Peyronie’s illness.

Nat Clin Pract Urol. Buy viagra 60 pills on new AmPills.com store Feb; 3(2):111-115

Written By Michael J. Metro, MD

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Brant WO, Dean RC, Lue TF

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