[New "conservative" treatments for Peyronie's disease-real alternatives or expensive pastime?].

Conservative treatment of Peyronie's disease (induratio penis plastica, IPP) remains largely unsuccessful despite decades of research, as the exact disease pathogenesis remains unclear. Currently, IPP is understood as a benign, localized, progressive connective tissue disorder of the tunica albuginea, in which repetitive microtrauma triggers an inflammatory process leading to fibrosis formation. The new "conservative" treatment approaches focus on immune-modulatory and regenerative mechanisms, but significant therapeutic success is still lacking. Treatments such as extracorporeal shockwave therapy, platelet-rich plasma (PRP), stem cell therapy, hyaluronic acid, and botulinum toxin are promising theoretical approaches, but their efficacy is often contradictory and they remain disputed and inadequately supported by studies. Research on these therapeutic approaches is often limited by extremely high costs and the regulations for clinical studies according to the Medicines Act, albeit necessary to further evaluate their effectiveness.