Review of Current Non-Invasive Peyronie's Disease Management: A Changing Reality.

Peyronie's disease (PD) is a fibrotic disorder that leads to plaque formation in 2%-9% of adult men. It causes a penile curvature that may hamper sexual intercourse. Treatment for PD may be challenging for urologists because of the multiplicity of treatment options available. Several clinical trials and case series have reported significant benefits in the treatment of PD. However, despite continuous updates to recommendations by international organisations, the available data remain limited due to the lack of randomisation, small cohort sizes, and poor patient adherence to therapy. Consequently, the level of evidence supporting recommendations for the andrology community remains low. This review aims to provide a comprehensive, evidence-based overview of current non-invasive treatment modalities for PD and highlights recent clinical practices and relevant clinical trials. We reviewed current clinical practice and ongoing clinical trials for the management of PD. Current treatment options for PD include oral drugs, topical approaches, intralesional injections, traction therapy and penile surgery which remains the gold standard. Intralesional therapy delivers the best evidence for non-invasive treatment. Collagenase Clostridium Histolyticum (CCH) is the only Food and Drug Administration (FDA)-approved treatment available, and its withdrawal has removed a promising first-line treatment option for PD. Emerging evidence suggests that penile traction therapy may enhance treatment outcomes and is a promising complementary approach in future therapeutic strategies.