Table 1. Case summaries of three patients with Peyronie’s disease treated by combined multimodal therapy
No. | Patient age | Comorbidities | Penile plaque site | Ultrasound measurements (length × width × thickness) and plaque volume (A) before and (B) after treatment | Type of deformity (A) initial and (B) after treatment | Pain score/VAS scale (1–10) | IIEF score before and after treatment | Total duration of treatment until plaque regression | Complete combined multimodal treatment |
|---|---|---|---|---|---|---|---|---|---|
1 | 50 years | None | Distal third | (A) 25.2 × 12.7 × 4.37 mm with inner calcification, 15.1 × 8.0 mm volume = 733 mm3 (B) No plaque detected | A) 5° ventral curvature + 5° left curvature (B) None | VAS score = 2 disappeared after 12 months | 27 > 29 | 53 months | Orally Propolis 600 mg + bilberry 160 mg + silymarin 400 mg + ginkgo biloba 250 mg + L-carnitine 1000 mg + coenzyme Q-10 100 mg + Boswellia 200 mg + vitamin E 30 mg/daily/for 53 months + topically diclofenac gel 4%/2 × daily/for 53 months* The patient refused peri-plaque penile injections with pentoxifylline |
2 | 26 years | Congenital (15°) right penile curvature | Proximal third | (A) 10.1 × 7.65 × 3.02 mm volume = 122 mm3 (B) No plaque detected | (A) 30° right penile curvature (B) 15° right penile curvature (previous condition = congenital lateral right penile curvature) | VAS score = 0 | 28 > 29 | 28 months | Orally: Propolis 700 mg + bilberry 180 mg + silymarin 400 mg + ginkgo biloba 240 mg + L-carnitine 1000 mg + coenzyme Q-10 100 mg + Boswellia 200 mg + vitamin E 48 mg + vitamin C 50 mg + superoxide dismutase 11,000 IU/g 10 mg/daily/for 28 months + topically diclofenac gel 4%/2 × daily/for 28 months + peri-plaque penile injections pentoxifylline 100 mg (30 G needle) every month for 12 months, and then one penile injection every 2 months for 12 months (18 total injections) |
3 | 36 years | Congenital (10°) dorsal penile curvature, lichen sclerosus, chronic prostatitis | Middle third | (A) 20.7 × 13.3 × 3.78 mm volume = 543 mm3 (B) No plaque detected | (A) 15° dorsal penile curvature + 20° left penile curvature (B) 10°e dorsal penile curvature (previous condition = congenital dorsal right penile curvature) | VAS score = 5 disappeared after 12 months | 25 > 29 | 44 months | Orally: Propolis 700 mg + bilberry 180 mg + silymarin 400 mg + ginkgo biloba 240 mg + L-carnitine 1000 mg + coenzyme Q-10 100 mg + Boswellia 200 mg + vitamin E 48 mg + vitamin C 50 mg + superoxide dismutase 11,000 IU/g 10 mg/daily/for 44 months + topically diclofenac gel 4%/2 × daily/for 44 months + peri-plaque penile injections pentoxifylline 100 mg (30 G needle) every 2 weeks for 6 months, and then one penile injection every month for 12 months, and then one penile injection every 2 months for 12 months (30 total injections) |