Complete Plaque Regression in Patients with Peyronie's Disease After Multimodal Treatment with Antioxidants: A Report of 2 Cases.

BACKGROUND Peyronie's disease is a chronic inflammatory disease involving the tunica albuginea of the penile corpora cavernosa. Conservative medical treatment includes oral therapy, intralesional injections, and physical treatment. No cases of Peyronie's disease with complete plaque regression after conservative medical treatment are described in the literature. CASE REPORT Case 1: A 50-year-old man presented with penile pain, combined penile curvature (left dorso-lateral), a palpable nodule, and normal penile rigidity. The patient underwent multimodal therapy with oral antioxidants, topical diclofenac gel, and periodic perilesional penile injections with pentoxifylline. At follow-up after over 3 years of multimodal treatment, the patient no longer had penile deformity or pain. Ultrasound imaging did not show any area affected by disease and plaque could no longer be observed. Case 2: A 55-year-old man presented with penile lichen sclerosus, dorsal penile curvature with onset about 6 months before, penile plaque, no penile pain, and normal penile rigidity. He underwent multimodal therapy with oral antioxidants, topical diclofenac gel, and periodic perilesional penile injections with pentoxifylline. At follow-up after over 3 years of multimodal treatment, he presented a dorsal curvature of the penis of about 5°, similar to his condition prior to the onset of congenital penile curvature. Ultrasound no longer showed plaque. CONCLUSIONS This study showed that multimodal combined antioxidant treatment had satisfactory results. However, to accomplish this, we deem it essential to have a correct ultrasound assessment that is performed with a sufficiently advanced machine by an operator with extensive experience in the field.