As a disease of the penis, induratio penis plastica is difficult to treat. With increasing severity it makes sexual intercourse painful or even prevents it. To date, the exact pathogenesis of IPP has not been fully explained.
istopathological studies show that a major cause is a disruption of collagen metabolism. Increased synthesis of Type III collagen was determined (this may be responsible for plaque formation) .
Surgical treatment of IPP does not achieve the desired result in all patients. As an alternative, several non-surgical forms of therapy were developed over the past few years. In a clinical study involving a total of 130 patients, 21 patients were treated with ultrasonic waves, 73 patients with Verapamil injections and 36 patients with ultrasonic waves in combination with Verapamil injections .
In 11 of 21 patients the plaques were reduced by the ultrasonic wave treatment. Although the authors recommend the treatment with ultrasound and Verapamil, the results of the combination therapy are not convincing.
Another study was able to show that the injection of betamethasone or placebo reduced the volume of plaque in 40% of the patients examined . In this study it was thus only possible to identify the mechanical effect of the injection volume as the actual effective mechanism. This study encouraged us to investigate a completely non-invasive procedure for the treatment of IPP that is described in the following case.
A 61 year-old patient has been receiving urological treatment for IPP since late 1999 without success. The patient has regularly attended the medical clinic for the purpose of monitoring a case of colitis ulcerosa and a constant microscopic hematuria. From a medical point of view the ulcerative colitis was in remission and kidney function normal.
Because the patient would not consent to an operation to correct the IPP, it was suggested he undergo a new non-invasive therapy. This showed remarkable results after only a few months. The patient was eager to see the results of his successful treatment published and gave his written consent.
He was acquainted with a heavy-duty bell condom (Phallosan). The principle of the bell condom is based on gentle but constant stretching of the penis (Fig. 1). In a lateral position, various degrees of tension can be exerted on the penis in one direction (Fig. 2).
For a more detailed description of the new product see the manufacturer’s instructions for use (http://www.phallosan.de). The latter sets out all hitherto known aspects of fitting and wearing of the heavy-duty bell condom and provides important tips for hygienic application.
The patient was instructed to wear the bell condom – initially for four to five hours daily – and to set the tension in the opposite direction of the penis curvature. Before the start of the treatment his penis was strongly curved as shown in Fig. 3a. Sexual intercourse had not been possible for several months.
Only 14 weeks into the treatment in which Phallosan was worn on average 4.5 hours (2.5–7.0) per day a degree of straightening of the penis was to be observed (Fig. 3b). The patient was able to engage in sexual intercourse for the first time in many months. After a further six months the curvature was substantially reduced (Fig. 3c).
The patient was delighted with the results and since its sexual function had been returned to normal he no longer considered the possibility of straightening the penis by surgery. No side-effects were experienced from the use of the bell condom. A rarely occurring reddening at the head of the penis disappeared after interrupting the therapy for a day. Although the patient now wears the bell condom only every other day for 3 to 4 hours, the success of the treatment has lasted until the present day – two years after the start.
Summary and outlook:
The heavy-duty bell condom (Phallosan, you can read more about it here) enables a new and completely non-invasive treatment of IPP. A straightening and normalization of the sexual function can be achieved by exerting tension on the penis for several hours a day in the direction opposite the curvature. Further studies with a larger number of cases will be necessary to determine whether the heavy-duty bell condom is also capable of remedying other types of erectile dysfunction. Reports by diabetics with erectile dysfunction and paraplegic patients are so far very encouraging.
1. Bichler KH, Lahme S, Mattauch W, Petri E: Collagen metabolism in induratio penis plastica (IPP). Urologist A. 1998; 37: 306-11
2. Mirone V, Imbimbo C, Palmieri A, Fuso F: Our experience on the association of a new physical and medical therapy in patients suffering from induratio penis plastica.
Eur Urol. 1999; 36: 327-30
3. Cipollone G, Nicolai M, Mastroprimiano G, Iantoro R, Longeri D, Tenaglia R: Betamethasone versus placebo in Peyronie’s disease. Arch Ital Urol Androl. 1998; 70:165-8
The author is known to the HGB AG and will be communicated after concrete inquiry.