Daily phosphodiesterase type 5 inhibitors plus acetylsalicylic acid improve curvature progression and pain intensity during the active phase of peyronie’s disease

The purpose of this study is that the combination effects of Peyronie's disease (PD) therapy with Phosphodiesterase type 5 inhibitors (PDE5i) plus acetylsalicylic acid on improve curvature progression and pain in the active phase of disease. We performed a retrospective cohort study of 161 patients affected by PD in active stage and erectile dysfunction treated with tadalafil 5 mg once daily were divided in two groups. Group A(GA): 93 men treated with only PDE5i (tadalafil 5 mg) for 1 year or more and Group B(GB): 68 men that received tadalafil 5 mg plus aspirin 100 mg with the same protocol of GA. The patients of both groups were assessed at baseline and follow-up (6 months) for erectile function, painful erections, penile plaque size, and penile curvature. Six months after the treatment the patients in both groups had a non-significantly reduction of penile plaques. However, in GB patients had a clinically significant reduction of the curvature after 6 months by treatments 20.21° ± 7.20 versus 28.13° ± 8.11 (GA), (<i>p</i> < 0.001). In the analysis of our secondary endpoint, we demonstrated a significantly lower intensity of pain during erection in GB (1.43 ± 1.12) compared GA (1.89 ± 1.25; <i>p</i> < 0.001). We observed that the regular use of this therapeutic combination significantly provided more benefit in patients with active stage PD in terms of penile deformity, pain, and discomfort during penetrative intercourses.