What is/are Potassium Aminobenzoate?
Peyronie's Disease, also known as "Induratio penis plastica" or more recently Chronic Inflammation of the Tunica Albuginea (CITA), is a connective tissue disorder involving the growth of fibrous plaques in the soft tissue of the penis affecting up to 10% of men. Specifically, scar tissue forms in the tunica albuginea, the thick sheath of tissue surrounding the corpora cavernosa causing pain, abnormal curvature, erectile dysfunction, indentation, loss of girth and shortening. A variety of treatments have been used, but none have been especially effective.
Without treatment, about 12-13% of patients will spontaneously improve over time, 40-50% will get worse and the rest will be relatively stable.
Medication and supplements
Many oral treatments have been studied, but results so far have been mixed. Some consider the use of non-surgical approaches to be "controversial".
Vitamin E supplementation has been studied for decades, and some success has been reported in older trials, but those successes have not been reliably repeated in larger, newer studies. A combination of Vitamin E and colchicine has shown some promise in delaying progression of the condition.
Some newer agents targeting the basic mechanisms of inflammation have been studied in larger clinical trials. These include potassium para-aminobenzoate (Potaba). pentoxifylline (acting through TGFβ1 inhibition), and Coenzyme Q10,. Other newer agents of interest include acetyl L-carnitine, propionyl L-carnitine, L-arginine, and sildenafil (acting through phosphodiesterase-5 inhibition).
The efficacy of Interferon-alpha-2b in the early stages of the disease has been reported in recent publications but it was found to be less effective in cases where calcification of the plaque had occurred in common with many treatments.
Formulations of superoxide dismutase are also reported to be effective in Peyronie's disease.
Injections to plaques (scar tissue formed by the inflammation) with Verapamil may be effective in some patients, but a recent placebo controlled trial failed to show a significant improvement. Use of iontophoresis with Verapamil and Dexamethasone, applied to the affected areas has been studied but the latest placebo controlled trial also failed to show a significant improvement. There are no clinical trials listed in the NIH trial registry. Topical Verapamil cream is also another option for patients who are unwilling to undergo penile injections.
Collagenase clostridium histolyticum (marketed as Xiaflex by Auxilium), a drug approved by the FDA to treat Dupuytren's contracture, has been reported to break down the excess collagen that causes Peyronie's disease. According to Auxilium, "the first phase II trials...showed promising results." The drug has not been approved by the manufacturer or the FDA for the treatment of Peyronie's disease, and such treatments are currently considered off-label use, and are discouraged.
Surgery, such as the "Nesbit operation", is considered a last resort and should only be performed by highly skilled urological surgeons knowledgeable in specialized corrective surgical techniques. A penile prosthesis may be appropriate in advanced cases. A European surgery called the Leriche technique, in which an 18 gauge needle is used to lacerate the plaque, has shown effectiveness at reducing curvature and returning sexual function.
Physical therapy and devices
Self-administered manual stretching techniques, as well as a number of devices which exert gentle longitudinal forces on the plaque, are currently being studied in clinical trials. However, these penis extenders are controversial and most doctors recommend staying away from them due to their unknown and potentially harmful side-effects. But there are a controversial minority who have endorsed such products.
Doctors are starting to look into less intrusive forms of therapy as an alternative to surgery because many patients were unhappy with the results of the intervention due mostly to the penile shortening that happens after the surgery. Although there is no cure for Peyronie's Disease or fibrotic disorders that are localized in different areas of the body (Fibrosis), several clinical studies such as the one mentioned above point to penis extenders as a possible treatment to correct curvature, or at the very least to impede the curvature from getting worse. According to Doctor Gontero, the leading Doctor of the above mentioned study which was published in the Journal of Sexual Medicine in 2009, "Overall treatment results were subjectively scored as acceptable in spite of curvature improvements, which varied from “no change” to “mild improvement.”" The study concluded that penile extender devices provided only minimal improvements in penile curvature but patients were generally satisfied likely from increased penile length. Several other studies exist which exhibit minor to moderate improvements in curvature, length and thickness but no cases of complete reversal of the Peyronies curvature.
In 2009 Dr. Timothy Abreu of the Gush Institute and Dr. Keith Kwon Nguyen of the Eastern Australian Men's Health and Fitness Association debuted a new suction-based treatment that showed promise in reducing the severity and discomfort of Peyronie's disease. Unfortunately the clinical trials were cut short after over 30 cases of necrosis.
Symptoms of low blood sugar include:
- Hunger, headache, confusion, irritability;
- Drowsiness, weakness, dizziness, tremors;
- Sweating, fast heartbeat;
- Seizure (convulsions); or
- Fainting, coma (severe hypoglycemia can be fatal).
Less serious side effects are more likely to occur, such as:
- Loss of appetite;
- Fever; or
- Mild skin rash.
This article uses material from the Wikipedia article Potassium Aminobenzoate, which is released under the Creative Commons Attribution-Share-Alike License 3.0.