Other Diseases

In general, urethral dilation, internal urethrotomy or urethroplasty can be used. The aim of the treatment, regardless of the technique used, is to re-establish the urethra’s normal calibre.

Urethral Dilation

This technique is intended to create a break in the scarred fibre without producing more inflammation and fibrosis.

Internal Urethrotomy

This is an endoscopic transurethral surgical procedure performed with a camera to directly view the stricture. Although the long-term success rate is low, it is the most commonly used primary technique, as it is less aggressive, faster and does not involve very invasive surgery.

Urethroplasty

Reconstructive surgery of the urethra is considered curative. It uses tissue transfer techniques (grafting or patching) to increase the urethral calibre.

Treatment for erectile dysfunction, like the treatment for diseases such as diabetes, high blood pressure or cholesterol, generally implies a chronic condition. Only in some very specific situations is it transitory and can be considered curative.

The treatment includes:

• Psychotherapy for psychogenic erectile dysfunction;
•  Medication (orally administered pills) of phosphodiesterase type 5 inhibitors (avanafil, tadalafil, vardenafil and sildenafil);
• Creams applied to the penis (alprostadil topical cream);
• Injections of this drug into the penis (intracavernous alprostadil);
• Penile prosthesis;
• Penile revascularisation surgery (rarely used today);
• Other (like the use of vacuum devices or a penile constriction ring);
• Hormone replacement therapy for erectile dysfunction due to hormonal issues. 

Adopting a healthy lifestyle and healthy diet, losing weight, doing physical exercise and being less sedentary, quitting smoking, and controlling glycaemia and cholesterol levels (i.e., controlling diabetes and dyslipidemias in patients suffering from these diseases) are associated with improving endothelial function and a significant reduction in the systemic markers for vascular inflammation with a consequent improvement in erectile dysfunction.

 

No effective medical therapy for this disease currently exists. However, medical therapy is used during the acute stage when the fibrous plaque is growing, i.e., in the 6–12 months at the start of the disease when the scarring is not yet complete.

The most effective treatment is surgical correction. This is advised in cases of significant and stable curvature when the angle is generally above 30 degrees or when accompanied by erectile dysfunction. It should only be performed when the curvature has been stabilised for at least 4–6 months.

The types of surgery (called corporoplasty) are the following:

• Tunica albuginea plication;
• Plaque incision;
• Incision with grafting;
• Excision with grafting;
• Any of these methods associated with a penile prosthesis.