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Peyronie's disease
What
is Peyronie's disease?
Peyronie’s disease is the presence of fibrous plaques
within the shaft of the penis. The plaques are formed in
the tissue surrounding the main erectile bodies, the
Tunica Albuginea, thus with erections the plaque will
cause bending and angulation of the penis. Sometimes the
bending is so marked that it makes sexual intercourse
impossible.
The exact cause is not yet fully understood and many
factors are thought to be involved. There may in some
cases be a family history or the patient themselves have
Dupuytren’s Contracture, where there are similar
fibrotic plaques in the palm of the hand. The condition
can affect men of any age and present with varying
degrees of curvature and severity, which is most visible
when the penis is erect.
Why is it called
Peyronie's disease?
Peyronie’s disease was named after Francois Gigot de La
Peyronie who, in 1743 described the characteristic
fibrotic, sometimes calcified plaque, under the skin of
the penis.
What are the main effects
of the disease?
The three main symptoms of Peyronie’s disease are pain
with erections, a palpable lump in the shaft of the
penis and curvature of the penis with erections. Not all
these symptoms may be present and their severity can
vary widely. Pain may occur initially with erections and
subside without treatment. At this stage, the patient
may start to become aware of a thickening in the shaft
of his penis. As the plaque develops, the penis may
become more noticeably curved when erect. If this
curvature increases to a severe angle sexual intercourse
may become uncomfortable for both partners or
impossible.
Some patients may develop erectile dysfunction problems
with the development of Peyronie’s disease, this may
have a psychological element secondary to the physical
changes caused by the disease.
Who can get Peyronie's disease?
Any man can develop Peyronie’s disease. The average age
of onset is 50 years, but it can occur in men as young
as 18 years.
Do others have this
condition?
This condition affects as many as 2% of the population.
Many men are however too embarrassed or afraid to go to
their doctor.
What should I do if I
think I have Peyronie's disease?
Go to see your doctor as soon as you feel any pain or
abnormal lumps in your penis. If Peyronie’s disease is
diagnosed, ask your doctor to explain about the
condition and the treatment options that are available.
If your doctor is unable to answer your questions,
request a referral to a consultant with a special
interest in male sexual health problems.
Sometimes, in 13% of patients the disease will clear by
itself, but this may take several years. However, there
are treatments available and the sooner the condition is
treated the earlier it can be helped.
What are the treatment
options and how long will the cure take?
Over the years a large number of treatments have been
used, but no single medical treatment has been shown to
be effective in all cases.
In the early stages, oral Tamoxifen has been shown to
produce an improvement by preventing the formation of
fibrous plaque, ( although this drug is also given for
the treatment of breast cancer the two conditions are
not related ). Vitamin E is a simple and sometimes
effective way to ease the pain and deformity of the
disease. It will not alter any underlying erectile
dysfunction.
Verapamil, a calcium channel blocker often used in the
treatment of Hypertension, has been shown to decrease
the plaque size and pain in Peyronie’s disease when
injected directly into the plaque.
Other treatments include colchicine, potaba and
interferon treatment.
There have been recent trials in the treatment of
Peyronie’s with extracorporeal shock wave therapy (ESWT),
although initial results have been promising, as yet the
long-term outcome is to be determined. Surgery is also a
very risky option.
What can Penileaid.com
do to help me?
When we started with Idaho, our resident Peyronie's
disease expert, he was suffering from a rather extreme
case of this disease. As you can see by his pictures he
has made a huge change in this problem. The routine he
used, which is geared towards correcting this disorder
is quite intense but the results are eveident when you
view the before and after photos.
Causes of a bent penis:
Weak and poor development of the corpora cavernosa
(Spongy tissue).
The penis consists of spongy tissue, the corpora
cavernosa. Imagine that the little openings in the
spongy tissue, on the one side of the penis are
developed to a lesser degree than that on the other
side; automatically the stronger blood circulation would
force the penis head over - furthest point of leverage,
causing a curved or banana shaped penis.
During Puberty
When young men get erections they often bend their
penises over to the left or right to hide the erection
in their pants. This affects the development of their
young penises. Blood can flow only through the 1 side of
the spongy tissue and 1 side of the penis develops more
than the other.
Injury
Acute or repetitive trauma (hitting or bending) causes
localized bleeding inside the penis. This leads to
fibrin deposition (scar tissue) in the tissue space that
accumulates after additional trauma. Collagen is also
trapped and pathologic fibrosis follows and even the
formation of calcium deposits. In addition, with age
there is a decrease in the elasticity of collagen
fibers.
Peyronie's disease
This is a condition where the internal tissue of the
penis turns to scar tissue on 1 side of the penis. The
plaque itself is noncancerous. Because this scar tissue
is hard and inflexible, it causes the penis to bend when
erect. A plaque on the top of the shaft (most common)
causes the penis to bend upward; a plaque on the
underside causes it to bend downward. In some cases, the
plaque develops on both top and bottom, leading to
indentation and shortening of the penis. It is also
possible that the penis may be hard at the base, but
soft at the top or skinny in the middle like an
invisible band has been fastened around it.
Unlike hypospadias, which is an accident of
birth, Peyronies is acquired during adult life. It can
come on fast and without any apparent reason; a man may
wake up one morning with his erection bent over. It
affects about 1 % of men. Most reported cases have been
white males in their forties and fifties.
Other causes
Vasoactive substance injection therapy, vitamin E
deficiency, the use of beta-blocking agents and
autoimmune phenomena.
Peyronie's Disease: Illustrated
Fibrous
plaque prevents uniform lengthening as erection occurs.
As the rest of the corpus cavernosum and corpus
spongiosum lengthen,
the penis bends toward the involved area.
A New Medical Treatment
for Peyronie's Disease
An exciting report from Italy shows that Peyronie's
disease can be cured by taking weekly injections of a
medication to treat high blood pressure plus a drug that
carries fat into cells (A). Three of 100 men suffer from
Peyronie's disease, a bending of the penis during
erection (1,2). The penis contains balloons that fill
with blood to cause an erection. These balloons can
develop a scar that prevents them from expanding
normally during an erection, causing the penis to bend
toward the scar. If you take a balloon and put a piece
of Scotch tape on one side and then blow up the balloon,
it will bend toward the side that has the Scotch tape.
Usually this is a harmless condition that requires no
treatment because the scar disappears, with no
treatment, within five years on the average. Impotence
associated with Peyronie's disease responds well to all
available treatments for impotence, such as injections,
pellets and Viagra. Doctors treat Peyronie's disease
only when it hurts to have an erection or prevents a man
from making love. Surgery often fails to cure this
condition, but this study shows that Peyronie's disease
was cured by injections of verapamil directly into the
scar in the penis (5 mg twice a week for 10 weeks) plus
a 3-month administration of propionyl-L-carnitine (2
g/day).
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