Peyronie’s Disease
Peyronie’s Disease is a condition whereby fibrous scar tissue forms in the penis, leading to curved, painful erections. Penises vary in shape and size, and having a curved erection is not necessarily a cause for concern. However, Peyronie's Disease can sometimes be severe and very distressing for the man.
What causes Peyronie’s Disease?
The exact cause of Peyronie’s Disease is unknown, but it is thought to result from repeated minor injury to the penis. This can be brought about by vigorous sex, though it can also be due to sports or other accidents. The resultant trauma causes scar tissue formation, or fibrosis, in the form of a plaque. In approximately 70% of cases, the plaque forms on the top, or dorsal, side of the penis. It is also postulated that immune-related conditions such as diabetes play a part in the development of Peyronie’s Disease.
Peyronie’s Disease occurs in approximately 4 out of 100 men between the ages of 40 and 70. Rarely, it can also happen in younger men. Actual numbers may be higher than estimated because many men may be too embarrassed about it to visit their doctor.
Aside from the curvature being aesthetically displeasing, other symptoms of Peyronie’s Disease are:
Painful erections
Lumps in the penis that can be felt
In severe cases, the curvature can be as much as 90 degrees, making sexual intercourse near impossible
Impacts a man’s confidence, mental health and quality of life
Is Peyronie’s Disease dangerous?
The condition is completely benign, and does not lead to an increased risk of developing penile cancer. Also, it does not affect a man’s fertility.
Phases
Peyronie’s Disease occurs in 2 phases:
Acute phase: Usually lasts for 5 to 7 months but can last up to 18 months. Plaque formation occurs during this phase. The bending of the penis gets worse and one experiences painful erections.
Chronic phase: The plaque stops growing and the penis does not bend any further. Erections are no longer painful by this time.
What can I expect at my visit?
Peyronie’s Disease can be diagnosed simply from a physical examination. Your doctor may be able to feel the plaque in the penis especially if it is erect. It may help to take a photo of the side view of the erect penis before consulting your doctor. If necessary, a penile ultrasound scan is performed to locate and assess the size of the plaque.
How is Peyronie’s Disease treated?
In about 13% of cases, Peyronie’s Disease resolves spontaneously without requiring any treatment. Therefore in mild cases where there is not much curving of the penis, no pain and no interference to sexual intercourse, it is advisable to watch and wait. In more advanced cases, treatment may be considered:
-
Certain oral medications such as vitamin E, tamoxifen and colchicine have been tried. However, most society guidelines do not recommend oral drugs because long-term studies have not shown convincing benefits.
-
Injecting straight into the plaque brings higher doses of the medication to the location of the problem than when taken orally. Plaque injection is often used for men with early Peyronie’s Disease or those who are not keen for surgery. The drugs used in such injections include collagenase and verapamil. There is a small risk of bleeding and penile fracture.
-
This is a painless treatment method whereby a machine is used to generate focused sound waves, which help to break up the fibrous plaque. Several treatment sessions are required before any improvement is seen.
-
This is recommended in severe cases, or when all other non-surgical methods have failed. Most healthcare providers suggest holding off surgery until the condition is in the chronic phase. The most common surgery performed is plication of the penis, which involves stitching the side of the penis opposite to the plaque. The main drawback is that the penis is shortened as a result.
Contact us.
If you think you may have Peyronie’s Disease, please don’t hesitate to make an appointment to visit our doctor. There are treatments available and you don’t have to suffer in silence.