Historical Contribution: 1948, Scott & Scardino, New Treatment for Peyronie’s

1948
A new concept in the treatment of Peyronie's disease W. W. Scott and P. L. Scardino Southern medical journal 1948 41: 173-177

 

Dorsal curvature of Peyronie's Disase.
From Wikipedia.

Peyronie's Disease is a connective tissue disorder caused by fibrous plaques in the penis that can cause pain, curvature, erectile dysfunction and/or difficulty with intercourse. In 1948, treatment of Peyronie's involved either surgical removal of the plaque, treatment with radiation and injection of a variety of agents – none of which worked particularly well and most of which caused erectile dysfunction. Drs. William Wallace Scott and Peter Scardino observed that Peyronie's Disease was present in patients with other connective tissue disorders – like Dupuytren's contracture (of the hands). Recognizing these similarities, Drs. Scott and Scardino attempted to correct the deformity of Peyronie's with tropical treatments effective for other connective tissue disease states.

 
Specifically in this manuscript they used a medication called tocopherol. Tocopherol is an organic chemical similar to Vitamin E. It was believed that these connective tissue disorders resulted from Vitamin E deficiency and replacing the Vitamin demonstrated promising results in early studies.

 
In treating 23 patients with Peyronie's, Drs. Scott and Scardino found that:

• Four (17%) cases demonstrated complete resolution of symptoms.
• Six (26%) had significant decrease in plaque size and symptoms.
• 15 (65%) had a moderate decrease in plaque/symptoms.
• Two (9%) had no change.

Drs. Scott and Scardino make an interstesting comment at the end of the manuscript: 

"The authors recognize that an occasional case of Peyronie's disease improves without treatment."

Today, we know that Peyronie's disease demonstrates an acute phase, when symptoms first present, and a chronic phase, where symptoms stabilize. The typical transition from acute to chronic phase takes approximately 12-18 months, during which time approximately 1/3^rd of patients will improve, stabilize and progress respectively. The authors of this manuscript recognize that some of their patients would likely have improved without any treatment, however the improvement in the majority of patients could be attributed, in part, to tocopherol treatment. Seventy years later, urologists and sexual medicine experts are still looking for the best medication to treat Peyronie's disease.

 
HISTORICAL CONTRIBUTIONS highlight the greatest academic manuscripts from the Brady Urological Institute over the past 100 years.  As the Brady Urological Institute approaches its centennial, we will present a HISTORICAL CONTRIBUTION from each of the past 100 years.  In the most recent experience, the most highly cited article from each year is selected; older manuscripts were selected based on their perceived impact on the field.  We hope you enjoy!