Peyronie’s disease Peyronie's disease

Peyronie's Disease

Have you noticed that your penis has a curve or become shorter or narrower than before? Do you have a plaque (a firm area on the penis)?

Visit Steinberg Urology for a consultation with our urologists to address your concerns, perform diagnosis and provide you on advice as to what treatments are likely to fit your individual circumstances.

PEYRONIE’S DISEASE

Peyronie’s disease is an inflammatory condition of the penis which causes scar tissue to form inside the shaft. The scar tissue causes an abnormal curvature of the penile shaft.

Peyronie’s disease is where plaques (segments of flat scar tissue) form under the skin of the penis. These plaques can cause the penis to bend or become indented during erections. The plaques can often be felt through the skin, and can also be painful.

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.

Peyronie's disease Peyronie's disease Normal Normal

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 curved 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.

Research has suggested these agents as possible causes of plaque or scar formation in the penile shaft:

  • Vitamin E deficiency
  • Beta-blocking drugs
  • Elevation in serotonin levels
  • Genetic causes
  • Trauma to the penis

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.

RISK FACTORS

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.

DIAGNOSIS

A physical exam is often sufficient to identify the presence of scar tissue in the penis and diagnose Peyronie’s disease. Rarely, other conditions cause similar symptoms and need to be ruled out.

Tests to diagnose Peyronie’s disease and understand exactly what’s causing your symptoms might include the following:

  • Physical exam. Your doctor will feel (palpate) your penis when it’s not erect, to identify the location and amount of scar tissue. He or she might also measure the length of your penis. The doctor will ask the patient about anything that may have happened before the symptoms appeared, such as an injury. If the condition continues to worsen, this initial measurement helps determine whether the penis has shortened.
  • Your doctor might also ask you to bring in photos of your erect penis taken at home. This can determine the degree of curvature, location of scar tissue or other details that might help identify the best treatment approach. Ideally, pictures of the erect penis taken from the (1) top down and (2) side will be helpful in assessment.
  • Your doctor might order an ultrasound or other tests to examine your penis when it’s erect. Ultrasound is the most commonly used test for penis abnormalities. Ultrasound tests use sound waves to produce images of soft tissues. These tests can show the presence of scar tissue, blood flow to the penis and any other abnormalities. Before the exam, you’ll likely receive an injection directly into the penis that causes it to become erect.
diagnostics

Penile Ultrasound Doppler

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.

MEDICATION

Taking a drug known as para-aminobenzoate or vitamin E tablets may be recommended for several months.
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SHOCKWAVE THERAPY

Shockwave therapy may be beneficial in the management of PD for penile pain and associated ED. SW therapy seems to be a safe and effective non-invasive modality in the treatment of PD and its subsequent complications.
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INJECTION THERAPY FOR MEN

For men with Peyronie’s disease the Injection Therapy has been shown to help straighten the penis shaft, allowing for better penetration during intercourse.
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INJECTION OF COLLAGENASE

Collagenase clostridium histolyticum is a medication which is used to treat Peyronie’s disease in adult men.
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PENILE TRACTION DEVICE

Penile traction therapy (PTT) consists of any treatment designed to lengthen or straighten the penis through mechanical forces. PTT is increasingly popular because of its relatively non-invasive nature, low cost, and minimal side effects and the lack of good alternatives to restore lost penile length.
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SURGERY

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.

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The images and/or videos are not presented as a guarantee of result. The results may vary. Patients gave their consent for the publication of images and/or videos.

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If you need to discuss this sensitive medical concern, schedule a consultation at our clinic in a safe confidential environment. Let us help you achieve optimal health and wellness in a professional setting.

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