A 50-year-old man with Type 2 diabetes presents with progressive penile curvature over 8 months causing painful intercourse. Examination shows a palpable plaque on the dorsal shaft with no tenderness. Curvature is 45 degrees. What is the most appropriate initial management?
- A Plication surgery (Nesbit procedure)
- B Conservative management with oral pentoxifylline or intralesional verapamil ✓
- C Penile prosthesis implantation
- D Penile traction therapy alone
Correct answer: B. Conservative management with oral pentoxifylline or intralesional verapamil
Explanation
In the acute/active phase of Peyronie's disease (typically first 12 months with ongoing pain or changing curvature), conservative management with oral agents (pentoxifylline) or intralesional injections is appropriate. Surgery is reserved for the chronic stable phase when curvature has been stable for at least 6 months. Plication and grafting are deferred until disease stabilizes.
Reference: Campbell-Walsh-Wein Urology, 12th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.