Peyronie's disease is a condition in which the penis bends abnormally, typically upwards or to one side. It is caused by the formation of hard plaque inside the penis. The exact reason the plaque forms is not fully understood, but in some cases it may begin with an injury that causes bleeding inside the penis, and in others there appears to be a genetic tendency.
It mainly affects middle-aged men, though it can also occur in younger and older men. People with diabetes are more prone to developing Peyronie's disease.
Symptoms
- The symptoms usually appear gradually. In more pronounced cases the plaque hardens, causing pain, reducing flexibility and forcing the penis to bend or arch when erect.
- In most cases the pain eventually settles, but the bend in the penis remains.
- Some men develop scar tissue elsewhere in the body, for example in the hands or feet.
- Men with Dupuytren's contracture, a scarring of the hand that affects the fingers, are more likely to develop Peyronie's disease.
- It can be associated with erectile dysfunction.
Diagnosis
- If you experience any of the above symptoms, you should see a doctor.
- The doctor will ask about your medical history and any injury that may have occurred before the symptoms began.
- The penis may be examined, and in some cases medication is injected to produce an erection so the curvature can be assessed.
- An X-ray or Doppler ultrasound of the penis may also be advised.
Treatment
In most cases the pain improves on its own without treatment. Doctors often prefer to wait a year or two before attempting any correction. If the curvature is mild and not interfering with your sex life, treatment is generally not advised.
In more severe cases, the following treatments may be considered:
- Oral medicines such as pentoxifylline or potassium para-aminobenzoate (Potaba) may be prescribed, although the evidence supporting them is limited.
- If these do not help, verapamil or collagenase (Xiaflex) may be injected into the scar tissue, though this too does not work in every case.
- If neither approach works, surgery may be considered. It is reserved for severe cases where the disease is significantly affecting the patient's sex life.
Surgical options
The two most commonly performed operations are:
- Removing the plaque and replacing it with a tissue graft.
- Removing or altering tissue on the side of the penis opposite the plaque to counteract the bend.
In some cases a penile implant is used. This option is generally reserved for men who have both Peyronie's disease and erectile dysfunction.
Other approaches, such as injecting chemicals directly into the plaque or shock wave lithotripsy, are used only rarely. They tend to relieve the pain rather than correct the curvature, and the pain usually resolves on its own in any case.
Every treatment plan starts with a proper assessment, so you only get the care your condition actually needs. If you have symptoms or a question about your health, book a consultation with Dr. Anish Gupta.