L-Arginine It is demonstrated that L-arginine could reduce the expression of collagen I, increase NO production, and inhibit ECM synthesis in Peyronies fibrotic plaques of animal model ( Pentoxifylline It is reported that pentoxifylline may reduce the TGF1 level in tissue and therefore have an anti-fibrotic role in rats ( in vitro to attenuate the deposition of collagen in tunica albuginea and reduce the secretion of TNF by T cells that are associated with the pathogenesis of PD ( Tamoxifen Independent of anti-androgen, tamoxifen serving as an oral agent in treatment of PD relies on its anti-fibrotic effects by inhibiting TGF1 via non-SMAD pathway ( in vitro and in vivo disease models ( Phosphodiesterase Type 5 Inhibitors It is reported that phosphodiesterase type 5 inhibitors (PDE5Is) might be a potential cause of PD due to increasing rigidity via oral PDE5Is making the penile deformity more obvious and increasing the susceptibility to penile trauma during intercourse ( Although amelioration of penile deformity was not examined in an RCT comparing shock wave therapy alone with shock wave therapy plus PDE5Is, other investigators drew the conclusion that continuous therapy of PDE5Is may be a candidate in treatment of PD based on the significant improvement of observational parameters ( Intralesional Medication Intralesional injection could deliver the agents into the pathological site with relative high concentration and avoid systemic side effects where possible
Adjunctive support : Joining a structured weight management programme, either through the NHS or a reputable commercial provider, can provide accountability, education, and peer support
But fascination doesnt always equal smart application
Your first visit starts with real data, not a questionnaire
Figure 23: Photograph of Professor Graeme Bell in San Francisco taken by Mitsuko Seino in the parking lot of Chiron Corporation, 1984, credit: Accili, Bell
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