Peyronie’s disease is an inflammatory condition of the penis which cause scar tissue to form inside the shaft. The scar tissue causes an abnormal curvature of the penile shaft.
Penises vary in shape and size, and having a curved erection isn’t necessarily a cause for concern. But Peyronie’s disease causes a significant bend or pain in some men. Peyronie’s disease can make sexual intercourse painful, difficult, or impossible. In extreme cases, scar tissue may cause shrinkage or shortening of the penis.
Symptoms of Peyronie’s Disease
The main symptom of Peyronie’s disease is the formation of flat scar tissue underneath the skin of the penis. The scars, called plaques, can feel like lumps to the touch.
Symptoms of Peyronie’s Disease can include:
- Lesions (plaques) under the skin of the penis shaft
- Curvature of the penis when erect
- Pain during erection
- Inability to successfully penetrate during sexual intercourse
- Indentation of the penis shaft (called “waisting”) giving it an hour glass shape
- Shortening of the penis
The scarring limits blood flow and in some cases, the penis cannot stay erect beyond the location of the plaques.
Peyronie’s disease is most prevalent in men between 40 and 70 years of age. Though it can affect younger men, the occurrence is rarer. A curved penis can be normal, but if you observe an increase in the amount of curvature, or if a crooked penis interfered with sexual activity or causes pain, it is advisable to consult with a urologist.
Causes of Peyronie’s Disease
The cause of Peyronie’s disease isn’t completely understood, but a number of factors appear to be involved.
It’s thought Peyronie’s disease generally results from repeated injury to the penis. For example, the penis might be damaged during sex, athletic activity or as the result of an accident. However, most often, no specific trauma to the penis is recalled.
During the healing process, scar tissue forms in a disorganized manner, which might then lead to a nodule that you can feel or development of curvature. In Peyronie’s disease, when the penis becomes erect, the region with the scar tissue doesn’t stretch, and the penis bends or becomes disfigured and possibly painful.
In some men, Peyronie’s disease comes on gradually and doesn’t seem to be related to an injury. Researchers are investigating whether Peyronie’s disease might be linked to an inherited trait or certain health conditions.
Peyronie’s disease is a benign condition that is not contagious, cancerous or related to sexually transmitted diseases. Milder cases may even go away on their own. “Watchful waiting” may be considered an effective approach if symptoms aren’t severe.
Minor injury to the penis doesn’t always lead to Peyronie’s disease. However, various factors can contribute to poor wound healing and scar tissue buildup that might play a role in Peyronie’s disease.
- Heredity. If your father or brother has Peyronie’s disease, you have an increased risk of the condition.
- Connective tissue disorders. Men who have a connective tissue disorder appear to have an increased risk of developing Peyronie’s disease. For example, a number of men who have Peyronie’s disease also have a cord-like thickening across the palm that causes the fingers to pull inward (Dupuytren’s contracture).
- Age. The prevalence of Peyronie’s disease increases with age, especially in men over 55.
Other factors — including certain health conditions, smoking and some types of prostate surgery — might be linked to Peyronie’s disease.
Treatment for Peyronie’s Disease
There is no cure for Peyronie’s disease, but it is treatable and may go away on its own. Treatment options include both medication and surgery.
A number of oral medications have been tried to treat Peyronie’s disease, but they have not been shown to be effective consistently and are not as effective as surgery. In some cases, drugs injected directly into the penis might reduce curvature and pain associated with Peyronie’s disease.
Depending on the therapy, you might be given a local anesthetic to prevent pain during the injections.
If you have a drug treatment for Peyronie’s, you’ll likely receive multiple injections over several months. Evidence on the effectiveness of penile injections is limited. These medications may also be used in combination with oral drugs.
Surgery is the last course of action in the case of severe penis deformity. Generally, you should wait at least a year before turning to surgery for Peyronie’s disease. Surgical solutions include:
- Shortening the unaffected side of the penis.
- Lengthening the scar tissue side.
- Penile implants.
Lengthening runs a greater risk of erectile dysfunction. Shortening the unaffected side is used when curvature is less severe. One type of shortening is a procedure called the Nesbit plication. In this procedure, doctors remove or cinch excess tissue on the longer side. This creates a straighter, shorter penis.
Surgery is the last course of action in the case of severe penis deformity. Doctors typically do not consider surgery a treatment option during the first year.
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