Is it possible to leave cavernosclerosis without treatment?

Timely treatment is recommended for cavernous sclerosis and Peyronie's disease. Long-term failure to treat it may lead to worsening of penile curvature or erectile dysfunction. Main intervention methods include oral medications such as vitamin E, colchicine, local injection treatments such as collagenase Clostridium histolytica injections, physical therapy such as traction devices, and surgical treatments such as plaque removal or prosthetic implantation.

1. Oral drugs:

Early-stage cavernosclerosis can be slowed down by medication. Vitamin E has antioxidant effects and may reduce fibrosis ； Colchicine can inhibit collagen deposition and is suitable for patients in the inflammatory stage. Some patients may use drugs such as L-carnitine or tamoxifen, which should be chosen under the guidance of a doctor.

2. Local injection treatment:

Moderate to severe patients can be treated with intralesional injection. Collagenase Clostridium histolytica injection can directly decompose plaque collagen and needs to be coordinated with ultrasound guidance for positioning. Glucocorticoid injections can relieve local inflammation, but may cause side effects such as skin atrophy.

3. Physical therapy:

The penile traction device improves the bending angle through mechanical force and is suitable for patients with mild deformity. Extracorporeal shock wave therapy can promote plaque softening and usually requires 6-8 sessions. Low-intensity pulsed ultrasound can improve local microcirculation.

4. Surgical treatment:

Surgery is considered when the disease lasts for more than 12 months and seriously affects sexual function. Plaque resection combined with graft repair is suitable for patients with curvature >60 degrees, but it may cause bleeding or abnormal sensation. Penile prosthesis implantation is suitable for people with erectile dysfunction.

5. Natural disease risk:

Untreated cavernous sclerosis may be self-limiting, but about 30% of patients will experience worsening of the curvature. Long-term lesions can lead to erectile pain, difficulty in sexual intercourse, and in severe cases, the formation of calcified plaques. Some patients may develop psychogenic erectile dysfunction.

It is recommended that patients avoid behaviors that aggravate blood vessel damage, such as smoking and alcohol abuse, and conduct moderate pelvic floor muscle training to improve local blood circulation. You can try warm compresses daily to relieve discomfort, but the temperature should not exceed 40°C. Regular ultrasound examinations are required to monitor plaque changes, and those with diabetes or cardiovascular disease need to control their underlying diseases at the same time. Sexual life should be suspended during the acute phase, and it is recommended to use water-soluble lubricants to reduce friction and irritation when gradually resuming after stabilization.