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What is the Best Treatment for Peyronie's disease? PRP and Stem Cells

Written by BioXcellerator | Sep 20, 2020 6:02:00 PM

Peyronie’s disease is a condition that often develops later in life and causes structural changes in the penis, leading to pain, deformation, and erectile dysfunction. Many men who suffer from this condition find it embarrassing to discuss and are reluctant to seek treatment. This can result in the condition becoming worse over time.

As the disease progresses, the symptoms worsen until they eventually reach a stable state. Unfortunately, there are few treatments currently available that are widely successful, and the surgical options that are available are invasive and may ultimately worsen the erectile difficulties experienced by a patient.

Fortunately, new advances in regenerative medicine including both stem cell therapies and therapies using platelet rich plasma provide new methods of treatment for this condition that may be able to provide another option to surgery. Patients will be happy to hear that these stem cell therapy and PRP therapy may be a treatment option that is far less invasive than traditional treatment methods. But first, let’s discuss what the disease is.

What is Peyronie’s Disease?

Peyronie’s disease is the name given to the condition where fibrous tissue forms inside of the penis, which can be painful and cause the penis to bend or shorten. This tissue appears in the form of plaques, or sections of scar tissue that build up in some areas of the penis. This most commonly happens on the upper surface of the penis, causing it to bend upwards.

The fibrous plaques build up over the course of around 3 to 12 months, until the condition stabilizes. They then interfere with the process of achieving and maintaining an erection and can also alter the structure and appearance of the penis, particularly when it is erect. As well as bending in a given direction, the penis may be shortened by the plaques, or have visible lumps where the plaques are located.

The underlying cause is unclear, although it is suspected that it is triggered by trauma to the penis. This trauma might occur during sex, or through a non-sexual impact to the penis. Since not every incident of trauma to the penis leads to the disease, scientists suspect that there are a range of underlying factors that might make an individual more or less susceptible to the disease.

The formation of plaques comes in two distinct stages, known as the acute phase and the chronic phase. The acute phase is the name given to the part of the condition while plaques are continuing to form, while the chronic phase is the name given to the part of the condition that occurs once the formation has ceased and the maximum amount of plaque is present.

Acute Phase

During the acute phase, a patient suffering from Peyronie’s disease is likely to feel pain in the penis and experience a progressive curving or shortening of the penis. Some treatments are available in this phase to reduce the impact of the symptoms while they are still developing.

Chronic Phase

At this point there are no further changes to the shape or structure of the penis, and the pain usually subsides. Some forms of treatments are best used in the chronic phase, once the full extent of the plaque formation has been determined.

Current Treatment Methods

There are very few treatments available to those who suffer from Peyronie’s disease. Most of the treatments are preventative and aim to reduce the impact of the plaque formation during the acute phase.

Medication

There are a variety of different medications that aim to reduce the impact of the plaque formation, but their effectiveness is very variable. Most medication-based treatments involve the medication being directly injected into the penis to ensure that the target area receives the maximum amount of medication.

The primary medication used to treat the disease is collagenase clostridium histolyticum. This medication breaks down the collagen that makes up part of the fibrous plaques that form during the acute phase. This reduces the severity of the plaques and can reduce the amount of curvature.

Several other medications are sometimes used to treat Peyronie’s disease, but there is limited evidence of their effectiveness. The type of medications generally used are those that fall into the category of inhibiting the formation of the plaques by disrupting part of a chemical pathway that leads to the production of some protein that contributes to the formation of the plaques.

Traction Therapy

With traction therapy, a specially designed piece of apparatus is applied to the penis in its flaccid state to alter the internal structure by applying pressure to force it into a more natural state.

Traction therapy is best applied during the early stages of the disease to prevent the structural changes caused to the penis by plaque formation. It has been shown to be effective both at reducing the amount of curvature of the penis as well as limiting the amount by which the penis shortens over time.

Surgery

Surgery is usually an extreme option for Peyronie’s disease, only recommended once the chronic phase has been ongoing for some time and in cases where the impact of the disease is most severe. In particular, it may be recommended when the curvature of the penis is so extreme as to limit the ability of the patient to have sex.

There are a variety of different types of surgery that may be effective depending on the exact nature of the individual patient’s condition.

In some cases, a surgeon can artificially straighten the penis by stitching together parts of the tissue on the longer side of the penis, to counterbalance the curvature. Because the curvature is towards the areas where the fibrous tissue has formed, this will overall lead to the shortening of the penis. Moreover, this approach is only effective when the final curvature of the penis is relatively small.

For more severe deformations, part of the plaque can be removed to reduce the overall amount of scar tissue present in the penis. Because of the large structural changes caused by this type of procedure, it is more likely to reduce the erectile function of the penis.

The lack of successful methods of treatment for Peyronie’s disease has led scientists to consider using recent developments in the field of regenerative medicine to try to treat the disease. There are a variety of new techniques that are known to be safe and non-invasive for patients, that may provide some help to those suffering from Peyronie’s disease.

Stem Cell Therapy for Peyronie’s Disease 

Recent advances in stem cell technologies have provided a new possibility of treatment for Peyronie’s disease. Stem cells can be derived from a variety of different sources, but all share the common feature of being able to differentiate into multiple different kinds of cells.

During the process of differentiation, stem cells also produce a variety of chemicals and growth factors that promote the growth and repair of a variety of damaged tissues. The stem cells also produce chemicals that regulate the body’s immune response, which can reduce inflammation and some of the other negative side effects related to an over-active immune response.

With Peyronie’s disease in particular, the relevant chemicals secreted by the stem cells during the differentiation process are those that reduce the production of structural proteins that contribute to the formation of the fibrous plaques.

Since the cause of Peyronie’s disease is unknown it is difficult to say for certain exactly what it is about the stem cells that is leading to treatment of the disease, or to what extent the treatment would be successful during the chronic phase of the disease.

In any event, stem cell treatments are known to be safe and relatively non-invasive. Wharton’s Jelly stem cells have been shown to be the best type of stem cell and are widely used for many therapies. They pose little to no risk of rejection by the body and the entire procedure can be undertaken with only a few injections, which is much less invasive than the kinds of surgeries that would be normally used for treating Peyronie’s disease.

Studies Examining Stem Cell Therapy for Peyronie’s Disease

There have been a variety of studies investigating the effectiveness of a number of stem cell treatments for the disease.

A key first step in developing stem cell therapies for this disease was carried out in the early 2010s, where scientists investigated the use of stem cell injections to treat Peyronie’s disease induced in rats. The stem cells used were taken from the rats in the study and re-injected into the damaged areas to investigate the effectiveness of stem cell treatments both for prevention of the progression of the disease, as well as treating patients in the chronic phase. A paper discussing multiple different treatment methods shows the results of the use of stem cell treatments.

These studies focused on results based around improving the ability of the penis to become erect. In this area, they showed great success, with rats who received stem cell-based treatments seeing improved erectile function compared to rats who did not receive the same treatment. While this is extremely encouraging and potentially presents a treatment path for human sufferers of Peyronie’s disease, it was also observed that none of the trials demonstrated a decrease in the size of plaques found in patients. At this stage then, the treatment seems like a good option for improving the function of the penis, or limiting the progression of the disease, but is unlikely to provide a full cure.

Another study carried out in 2015 investigated the use of stem cell-based treatments for human patients suffering from Peyronie’s disease. Rather than using stem-cells derived from the patient’s own tissues, this study used stem cells obtained from placentas. This form of stem cell has a greater ability to differentiate when compared to adult stem cells and is likely to be able to produce more growth factors as well.

The study investigated changes to the volume of plaques found within the penis, as well as the degree of curvature and erectile function at intervals of 6 weeks, 3 months, and 6 months. The results showed improvements in some aspects of erectile function, as well as a reduction of size or entire disappearances of some of the plaques being treated. This is highly encouraging for the possibility of improved treatments in the future.

Another form of regenerative medicine, PRP therapy has also shown some promise in treating the disease.

Platelet Rich Plasma for Peyronie’s Disease

Using stem cells is not the only new approach to treating Peyronie’s disease. In recent years, scientists have developed a form of treatment known as platelet rich plasma therapy that uses key elements from a patient’s own blood to heal damaged tissues.

Platelet rich plasma therapy extracts blood from a patient and then separates it out into its component pieces by spinning it in a centrifuge. Then the plasma and platelets are taken from the mixture and re-injected into the patient.

The plasma is the part of the blood that consists of liquid and dissolved chemicals, while the platelets are small cell fragments that play a key role in the mechanical and chemical processes involved in clotting and repairing damaged areas in the body. When re-injected into a patient, these parts of the blood contain key growth factors that help to repair damage in combination with the healing aspects of the platelets.

Platelet rich plasma therapy uses parts of a patient’s own blood and contains no foreign agents, and therefore does not provoke an immune response. This makes it a very safe form of treatment, while also being minimally invasive.

Studies Express Hope for PRP Therapy

Given the relative newness of this form of treatment, there is currently a lack of studies that investigate using it to treat Peyronie’s disease. That said, there have still been a number of studies with positive results.

One such study was carried out in 2017 to investigate the use of platelet rich plasma treatments in human patients suffering from Peyronie’s disease. The treatment consisted of a series of 5 injections over a period of 2 months, and analysed the changes in curvature, size of the plaques, and erectile function.

The study showed that treatments with platelet rich plasma were able to provide improvements to the curvature of the penis, as well as a reduction in the size of the plaques found within it. In addition, patients experienced improvements in erectile function and almost half of those treated experienced easier sexual intercourse. That is incredible news for patients. Instead of having to undergo risky surgery, they may be able to utilize PRP therapy.

Combination of Stem Cell Therapy and PRP

Both stem cell-based therapies and therapies using platelet rich plasma provide a relative non-invasive path to treatment for patients suffering from Peyronie’s disease. Given that they both work with similar underlying mechanisms, there is a potential to combine the treatments for an increased chance of success.

One of the hallmarks of current treatments for Peyronie’s disease is that they may be very successful, but only in some patients. Different individuals respond differently to the treatments which means that the same therapy that mostly cures one person might have little impact on another. Therefore, by combining a number of different treatments, patients are more likely to find something that works for them. This also allows for the potential that the combined treatments augment each other and work better together than they would have done individually.

Reach out to BioXcellerator today to learn more about how stem cell therapy and PRP therapy can help with Peyronie’s disease. The power of regenerative medicine could spare you from pain and improve your quality of life.