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Peyronie’s Disease

Peyronie’s Disease is the result of the formation of hard, flat plaque that forms under the skin on the tissue of the penis. This plaque often originates as an inflammation issue that can turn into scar tissue. This can cause pain in the penis, and in some cases, cause the penis to develop a sharp curve during erections. Penises can vary in shape and size, and having a curved erection does not necessarily mean there is an underlying issue or cause for concern.

Researchers estimate that diagnosed Peyronie’s Disease affects 0.5% of American adult males.  There is an estimated 8% – 10% of American adult males live with undiagnosed Peyronie’s Disease.

Causes of Peyronie’s Disease

What causes Peyronie’s disease is not exactly clear, although, there are a number of factors that seem to be involved.

The general consensus is that Peyronie’s develops after repeated injury to the penis. This could be an injury sustained during sex, athletic activity, or by mere accident. However, more often, no specific trauma to the penis is recalled.

During the healing process, scar tissue will form in an unorganized manner, which might then lead to a nodule that you can feel or the development of a curvature. Each side of the penis contains a sponge-like tube, corpus cavernosum, that contains tiny blood vessels. Each of the corpora cavernosa is housed in a sheath of elastic tissue called the tunica albuginea, which stretches during an erection. When a man becomes sexually aroused, blood flow to these chambers increases. As the chambers fill with blood, the penis expands, straightens, and stiffens into an erection.

With Peyronie’s Disease, when the penis becomes erect, the region with the scar tissue will not stretch, the penis bends or becomes disfigured, and possible pain ensues. In some cases, Peyronie’s disease develops gradually and will not seem to be related to an injury. The medical community is researching whether Peyronie’s disease might be linked to an inherited trait or other certain health conditions.

Symptoms of Peyronie’s Disease

As stated above, the symptoms of Peyronie’s Disease may appear suddenly or develop gradually. The most common symptoms include:

  • Scar Tissue – The development of scar tissue, in relation to Peyronie’s Disease, can be felt under the skin of the penis as flat lumps or even a band of harder tissue.
  • A Severe Bend to the Penis – The penis may develop an upward curve, downward curve, or a bend to the left or right. Some cases have shown that an erect penis may have narrowing indentations or an hourglass shape that is usually accompanied with a tight, narrow band around the shaft. The curvature may gradually worsen, but at some point, it usually stabilizes.
  • Shortening of the Penis – The penis may become shorter as Peyronie’s Disease develops.
  • Erectile Dysfunction – Peyronie’s Disease may cause men to have problems getting or maintaining an erection.
  • Pain – Those suffering from Peyronie’s disease may experience penile pain, with or without an erection. Pain during an erection usually improves within one to two years, but the scar tissue and curvature often remain.

Treatment Options for Peyronie’s Disease

The ultimate goal of treatment is to reduce the pain associated with Peyronie’s Disease as well as keeping you sexually active. Unfortunately, there is no cure, but education about the disease and its course is usually included in the treatment plan prescribed by your physician. There are certain cases of Peyronie’s Disease where treatment is not necessary, such as Mild Peyronie’s Disease, which has the ability to heal on its own in about 6 to 15 months.

There are surgical treatments for Peyronie’s Disease that are quite effective. These procedures cause minimal discomfort, and are performed as an outpatient procedure. Surgical treatments may include:

  • Suturing (plicating) the unaffected side – This may include a variety of procedures, but the longer side of the penis (the side without scar tissue) is sutured. This results in a straightening of the penis, although this is often limited to less severe curvatures and may result in greater actual or perceived penile shortening.
  • Incision or excision and grafting – With this procedure, the surgeon makes one or more cuts in the scar tissue, allowing the sheath to stretch out and the penis to straighten. The surgeon may also remove some of the scar tissue as well.
  • Penile implants – These surgically implanted penile implants replace the spongy tissue that fills with blood during an erection. These implants may be semirigid – manually bent down most of the time and bent upward for sexual intercourse.

The type of surgery used will more than likely depend on the severity of your condition. Your physician will consider the location of the scar tissue, the severity of symptoms, and several other factors.

Additionally, there are several non-surgical treatment options for Peyronie’s disease available. Options like plaque injections with Xiaflex or Verpamil can occasionally be useful to treat Peyronie’s Disease, as well as vacuum erection devices that can help in stretching and remodeling the scar tissue.

Other treatment options for Peyronie’s disease are being investigated, but the evidence is limited on how well they work as well as their possible side effects. These include intense sound waves to break up scar tissue (shock wave therapy), devices to stretch the penis (penile traction therapy), and radiation therapy.

Dr. Brian Christine and Dr. David Qi, UCA’s experts in men’s sexual health and prosthetic urology, are two of a limited number of surgeons who have been trained to offer Xiaflex as a treatment option for men suffering from Peyronie’s disease. If you or someone you know is experiencing signs or symptoms of Peyronie’s Disease, contact Urology Centers of Alabama to schedule an appointment or call us at (205) 930-0920 and begin your road to recovery.

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