Treatment of Peyronie’s disease

When you come for your first consultation, Michael will go in-depth on the whole issue, both with physical and psychological effects. The first consultation takes place as follows:

1. A thorough screening of the degree of curvature, your physical and mental health and medical history and its possible impact on your ability to travel
2. We do a high-quality ultrasound scan to reveal the size of the fibrosis/plaque (the lump/strand you feel).
3. We identify your expectations of the treatment and the level we expect to be able to take you to, based on the results of the survey.
4. You will receive the first treatment with pressure wave and EMTT, if you wish to proceed with the treatment. Here you will be instructed on home exercises to do between treatments to ensure a good result.

When starting treatment, it may be beneficial to bring a picture of the erect penis to show the location of the curvature. This way, we can better target the treatment. Otherwise, we also have an imitation, so we can see exactly what your penis looks like if you’re not comfortable taking a picture.

We go in-depth to make sure we can implement the right treatment strategy to restore quality to your sex life. The treatment and examination is performed by one of the leading experts in urological pressure wave therapy in the Nordic countries, Michael, who is also a member of The International Society for Sexual Medicine .

The treatment is focused shockwave therapy, also known as ESWT (Extracorporeal ShockWave Therapy). This is done by “shooting” high-frequency sound waves via an application head into the fibrosis/plaque area. This allows the biological processes around the ‘ball’ itself to be altered so that it breaks down into a less solid form. This means that when we affect the plaque area during the course of treatment, it will be broken down into smaller pieces, so that the curvature is reduced. The processes set in motion can be reinforced by a few different home exercises, which you will be taught when you come for treatment.

In particular, the biological processes related to collagen conversion, stem cell release, cell communication and blood vessel formation, are the reasons why we can use pressure wave therapy effectively for peyronies. When we combine it with EMTT it is because it has an increased overall stimulation, which makes the tissue more elastic and flexible. There are no other clinics offering this combination treatment in Denmark. When the tissue is stiff, it also helps to increase curvature and can in certain cases result in a shortening of the penis.

The treatment itself involves applying a gel to the penis where the fibrosis is located, followed by shooting a series of impulses into the tissue, depending on what we have identified through the ultrasound scan. The treatment may feel prickly and tingly. In rare cases, you may feel a slight soreness after treatment. You can use your penis as normal throughout the treatment.

In order to determine the degree of fibrosis/plaque, it is necessary to do an ultrasound scan – it is not enough to “just” feel. This also ensures that we treat the right area during the subsequent shockwave treatment. Ultrasound scanning for peyronies is only offered by a few clinics in Denmark, and thus Michael has extensive experience and knowledge in detecting fibrosis/plaque in the penis. It can also identify whether it is the connective tissue that is tight and whether that is the problem. This is important to give a prognosis to the course of treatment, and the subsequent outcome. We help you understand this when we do the scan. See different examples of different sizes of penile fibrosis here.

A normal course of treatment lasts 6-8 weeks with 1 weekly pressure wave treatment, where we give a series of pressure wave impulses in the area where the hard “ball/string” is located. We supplement with EMTT to increase the elasticity of the tissue so that it recovers more ‘in place’. This means that we get faster results in the clinic than with shockwave therapy alone. After the course of treatment, you can expect a smaller curvature, less pain in the area, as well as increased sexual function. In addition, multiple cases of fibrosis may require additional treatments.

• It costs 1,200 kroner per treatment with the combination of shockwave and EMTT
• The first examination costs NOK 2,400, including an ultrasound scan.
• As one of the few clinics in Denmark, and the only one in Copenhagen, Michael works directly with Storz Medical in Switzerland. They are the leading manufacturer of pressure wave therapy equipment for urological conditions, so we are fully up to date with the latest research and technology in the clinic and have access to specialist equipment for the treatment of peyronie’s disease.

Induratio penis plastica can be likened to an inflammatory condition, which typically first manifests itself by pain and tenderness in the penis. It is usually most noticeable when erect during intercourse, and can therefore affect sex drive. It can also, in severe cases, lead to Erectile dysfunction .

Peyronie’s disease, which is not congenital, can occur during life and may be caused by an autoimmune reaction, possibly triggered by small injuries to the penis during sexual activity. This is where thickened, tender nodules develop in the tumour bodies, causing pain and discomfort. Note that the condition is completely harmless. During the inflammation phase, it is possible to reduce the pain with pressure wave therapy and EMTT, as well as slowing down the condition.

Whether congenital or acquired later in life, mild penile deviation does not cause any symptoms or pain. Bias should only be treated in cases where the degree of bias makes sexual intercourse difficult or impossible.

The condition normally has a two-stage course:

1. The first phase often lasts one year and is marked by painful erections, while the penis starts to curve and become deformed
2. In the second phase, the soreness decreases. Here, the painful areas heal with stiff scar tissue, also called plaque. The result can be an hourglass-shaped penis when erect, or curvature of the penis.

The condition does not heal on its own and treatment is necessary. Studies show that 10% experience improvement after 5-10 years, 40% experience a stable condition and 50% experience worsening over time.

Congenital curvature of the penis is relatively rare, affecting less than 1% of men.

In contrast, Induratio penis plastica is not uncommon. The incidence rises with age, affecting up to 13% of the male population to varying degrees. Not everyone is embarrassed by it and it is rare that the condition is so extensive that sexual intercourse with a partner becomes difficult.

As a non-invasive treatment, pressure wave is the most effective. However, in severe cases, surgery is currently the most effective treatment and 50-75% of curvatures are satisfactorily corrected. At least one year must pass from the end of the curvature process until surgery is offered. In the clinic, Michael sees many clients who have already had surgery without the desired result. Here we see an improvement in the condition with shockwave therapy afterwards.

A man’s penis is in many cases the source of his self-confidence and who he is. If his self-image breaks down and he feels that he has no greater value, or that he is unable to perform because his penis doesn’t look or perform as well as it used to, it can lead to a wide range of psychological issues. It can manifest itself in the form of shame and performance anxiety, and in severe cases, depression and stress.

When his self-esteem disappears and he feels inferior, the desire for sex, and in the most severe cases, the ability to have sex, will disappear for him. It will create a vicious circle that further affects self-image and sexual function. For him, this will need to be addressed in order for him to regain successful sexual functioning.

Michael also helps you with the psychological impact that comes with the condition.