Oxidative Mechanism of Peyronie's Disease and Effectiveness of Pentoxifylline in the Therapeutic Management: A Narrative Review

Abstract

Peyronie's disease (PD) is a chronic disease characterized by the development of fibrous tissue in the tunica albuginea of the penile corpora cavernosa that causes penile deformity. The precise cause of PD is not completely understood, but it is generally believed to be initiated by a specific injury in the affected area. Research has consistently shown that oxidative stress (OS) is a key player in PD. Pentoxifylline (PTX) is a synthetic derivative of methylxanthine that was initially used for the management of peripheral vascular disease. PTX has also been used in humans for several inflammatory and fibrotic conditions, including PD. PTX has several mechanisms of action, including antioxidant, antifibrotic, anti-inflammatory, and vasorelaxant. This article aims to verify, after a review of the literature regarding the use of PTX in PD, whether this substance is really able to cure PD. We conducted research by consulting the scientific literature on the topic. Results: After examining 39 articles, we considered 20 articles eligible for our narrative review, including a single randomized controlled clinical study, six clinical studies with a control group, a single uncontrolled clinical study, eight case report studies, and four systematic review articles. Conclusions: Although the systematic review articles selected in this paper showed no consistent evidence regarding the efficacy of PTX, in our opinion, the clinical studies we have analyzed undoubtedly demonstrate that PTX is able to combat PD, thanks to its ability to interfere with the pathogenic mechanisms of the disease. However, we believe that further new randomized controlled trials are necessary to more clearly demonstrate the effectiveness of PTX in the treatment of PD.

Keywords: Peyronie’s disease; antioxidants; oxidative stress; pentoxifylline.

Figure 1

Explanatory flow chart of the narrative revision methodology.