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Urology/curvature,pentoxyfilline

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Question
hello,DR LESLIE,

my name is david,i am 44 years old.
i have a penile curvature of about 20 degrees,this curve is not congenital,and i noticed it since 2 years ago.
i have been to many urologists,who could not detect by physical examination any plaques or scarring or peyronies disease.
i can still have sex ,but,my erections are weaker than before.
i have read that pentox can reverse the curvature and ameliorate it,so,i need to ask:

1) do u recommend that i take pentox for 6 months,to see if it would be beneficial in reversing my curvature...?

2) is the use of pentox completely safe? does it have any side effects?

3) can the potential benefits of pentox regarding the curvature,be obtained if used alone,or must i use a daily low dose of viagra or cialis along the pentox for optimal and maximal benefits...?

4) what are currently the most reliable and efficaious non surgical and oral treatments  that urologists recommend for penile curvatures...?

thank you DR LESLIE,

Answer
David:

Pentoxyfilline is certainly safe as its been used for years.  Its effectiveness for Peyronie's and curvature is suggested but not proven.  So it's worth a try.  Listed possible side effects are:

Chest pain, Irregular heartbeat, nausea, indigestion, vomiting, dizziness and headache.  These are just possible side effects and are relatively rare.  I've never had a patient who actually had any side effects from the drug.

You might also want to consider the use of a penile stretching/lengthening device such as Fastsize which has also been shown to deal with curvature.  Negatives include the need to where such a device daily for weeks/months and the possibility of overuse or overstretching which can lead to scarring, neuropathy, numbness and penile discomfort.

It is not known if the optimal benefits from pentoxyfilline require Cialis/Viagra or not.  I tend to recommend a daily Cialis for whatever benefit it might provide.

There are no reliable, effective, proven non-surgical oral therapies for penile curvature.  The next step might be penile plaque injections.  We typically use Verapamil but there is a new injectable drug called Xiaflex which has shown benefit but has significant potential side effects. You should discuss this with a urologist.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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