Peyronie’s Disease
What Is Peyronie’s Disease?
Peyronie’s Disease is a curvature of the penis caused by a buildup of scar tissue within the penile shaft. The condition is not life-threatening, but may cause painful erections and impact sexual performance and function.
Peyronie’s Disease impacts the mechanics of erection by constricting areas of the penile shaft. Each side of the penis contains a chamber of blood vessels encased in an elastic sheath called the tunica albuginea. During sexual arousal, blood flow to these chambers increases, and the tunica albuginea expands to form an erection. However, in patients with Peyronie’s Disease, scar tissue within the penis prevents the tunica albuginea from expanding fully, resulting in a bent, disfigured, and possibly painful erection.
Peyronie’s Disease Symptoms
Symptoms of Peyronie’s Disease include:
- A curved, painful erection
- Flat lumps or bands of hard tissue located around the penile shaft
- Shortening of the penis.
- ED – Peyronie’s disease may cause erectile dysfunction
Peyronie’s Disease Complications
The primary complication of Peyronie’s Disease is erectile dysfunction (difficulty achieving and maintaining an erection). Secondary complications include anxiety, stress, depression, and infertility resulting from an inability to achieve or complete sexual intercourse.
Peyronie’s Disease Causes
The cause of Peyronie’s Disease is unknown. Some researchers believe that scar tissue may develop as a result of significant trauma or repeated injuries to the penis. However, in some patients, the symptoms of Peyronie’s disease appear suddenly and cannot be attributed to any known prior injury. Other researchers are investigating the possibility that Peyronie’s disease is a congenital disorder or is derivative of other medical conditions.
Peyronie’s Disease Diagnosis
Typically, a physician can diagnose Peyronie’s Disease during a physical exam by identifying bands of scar tissue in the penile shaft. The doctor will manually examine the flaccid penis to locate rough, rigid tissue, and may measure the length of the penis to monitor future reduction in size.
If a physical exam is inconclusive, the doctor may order additional tests or injections to assess the presence or severity of scar tissue.
Ultrasound tests, which use sound waves to produce images of soft tissues, are the most commonly used tests to diagnose Peyronie’s Disease. The doctor may administer an injection to the penis to induce erection so that the scar tissue may be more easily located.
Peyronie’s Disease Treatment
Occasionally, symptoms of Peyronie’s Disease improve or disappear without treatment. But in many cases, symptoms persist or worsen.
Treatment options include:
- Medication: A number of medications may be used to treat Peyronie’s Disease, though their effectiveness varies from patient to patient:
- Pentoxifylline, an oral medication that may reduce the amount of scar tissue
- Collagenase (Xiaflex), an injectable medication that breaks down collagen proteins in scar tissue, and is most effective when used simultaneously with physical therapy techniques such as stretching the penis in a direction opposite of the curve
- Verapamil, an injectable medication normally used to treat high blood pressure, which appears to disrupt the production of collagen proteins in scar tissue
- Interferon, a protein that appears to disrupt the production of scar tissue
- Physical Therapy: Physical therapy such as penile traction therapy in which a stretching device is applied to the penis to reduce curvature.
- Iontophoresis: A procedure that administers topical Verapamil to scar tissue via a mild electric current.
- Plication Surgery: A surgery in which scar tissue is pinched together on the outer edge of the curvature.
- Grafting Surgery: A surgery in which scar tissue is replaced with healthy tissue.
- Penile Implant Surgery: A surgery in which a prosthesis is inserted into the penis.