What is Peyronie's disease?

The causes, signs and symptoms of this painful penis curvature.

Peyronie’s disease is fairly common with an estimated 3% to 9% of men experiencing the condition. It’s more common among older men and risk increases with age. The symptoms are not always obvious in a flaccid penis, but when the penis becomes erect, it will appear curved, shortened and narrower. Patients may also experience pain from this curvature.

 

The condition is due to plaque (or scar tissue) accumulating in the penile shaft. Researchers aren’t entirely sure what causes the condition. Repeated trauma due to injury or repeatedly hitting the penis are believed to be some of the main reasons for Peyronie’s disease. There may even be genetic reasons for the plaque build-up. Penile fractures, however, are not the cause of the disease. According to a study of 63 cases with a broken penis, their fractures did not cause Peyronie’s disease.

 

Patients will usually notice pain during sex and the penis may feel different (e.g. painful on one side). Symptoms can arise suddenly or develop gradually over time. An assessment of 118 men with the condition found that a deformed penis was usually the first noticeable symptom (52%), followed by pain (40%) and a lump (21%). The condition may eventually lead to increased inflammation, fibrosis and erectile dysfunction.

 

Peyronie’s disease and erectile dysfunction

An estimated 22% to 54% of patients with the condition also have erectile dysfunction. Although the biological basis for the connection between the two conditions is not well understood, studies suggest that erectile dysfunction could arise because of vascular issues. Research by the Princess Alexandra Hospital in Australia, which followed 1,120 men over 10 years, noticed that plaque size and erectile dysfunction were correlated, and this was likely due to hampered function of the arteries.

 

Peyronie's disease could affect sexual activity in a few other ways. Some patients may be unable to have intercourse due to pain, a flail penis or anxiety and depression.  

 

How is Peyronie’s diagnosed?

If you notice any sudden pain or deformities of your penis, you should consult a doctor. During your examination, your physician will usually be able to feel if the tissue has hardened. You may also require an ultrasound or x-ray to confirm any diagnosis.

 

What are the treatment options?

If your penis curvature is less than 30 degrees and you do not experience any pain, it’s unlikely that you have Peyronie’s disease.

Men with the condition are usually prescribed medication for six to twelve months. This includes Potaba, Tamoxifen, but also supplements such as Vitamin E and acetyl l-carnitine. You may also be prescribed penile injections with verapamil or collagenase. Both of these medications work by breaking down the build-up of collagen causing the curved penis.

 

If these treatment approaches aren’t successful or your curvature is severe and causes you great pain, you can undergo surgery. For less severely curved penises, a surgeon may choose to suture the unaffected side of the penis. In other cases, a surgeon will make an incision to remove the scar tissue. This allows underlying tissues to stretch and as a result, the penis will usually straighten again.

 

Where patients have both Peyronie’s disease and erectile dysfunction, penile implants have proven to be a successful intervention. Implants have two functions: they correct the penile curvature and provide upward support during sexual intercourse.

 

If you think you may be suffering from Peyronie’s disease, it’s important to visit a doctor as soon as possible.

 

References

  1. Jalkut, M., Gonzalez-Cadavid, N., & Rajfer, J. (2003). Peyronie's Disease: A Review. Reviews in urology, 5(3), 142–148.
  2. Serefoglu, E., Trost, L., Sikka, S., & Hellstrom, W. (2014). The direction and severity of penile curvature does not have an impact on concomitant vasculogenic erectile dysfunction in patients with Peyronie’s disease. International Journal of Impotence Research, 27/1: 6-8. https//doi.org/10.1038/ijir.2014.25
  3. Acikgoz, A., Gokce, E., Asci, R., Buyukalpelli, R., Yilmaz, A., & Sarikaya, S. (2011). Relationship between penile fracture and Peyronie's disease: a prospective study. International Journal of Impotence Research, 23/4: 165-172. https//doi.org/10.1038/ijir.2011.24
  4. Pryor, J., & Ralph, D. (2002). Clinical presentations of Peyronie's disease. International Journal of Impotence Research, 14/5: 414-417. https//doi.org/10.1038/sj.ijir.3900877
  5. Ateia, A. H., Voinescu, O., & Geavlete, R. (2012). Penile prosthesis in the surgical treatment of Peyronie's disease. Journal of medicine and life, 5(3), 280–282.

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