From fibrosis to restoration: the multimodal 3 Ts protocol for Peyronie’s disease

AUTHORS

Dimitrios Hatzichristou

ABSTRACT

Traditional management strategies for Peyronie’s disease, largely monotherapeutic and stage-dependent, have produced inconsistent outcomes and rarely address the underlying biology of fibrosis. Based on existing knowledge, a multimodal novel concept, the 3Ts Protocol, is presented, involving Tadalafil daily, Tunneling with intralesional biologics, and daily Traction therapy. It introduces a comprehensive, regenerative strategy that integrates pharmacologic, biologic, and mechanical interventions in a single sequence. Daily low-dose tadalafil improves cavernosal oxygenation and arterial inflow, counteracting hypoxia-driven fibrosis.