Peyronie's disease is an erectile disorder characterized by a curvature of the penis and erection deformity. It's caused by the scarring of the tunical albuginea (a thick membrane that protects the erectile tissues), and results in pain during erection and intercourse.
"The most likely cause is an injury to the penis, probably during coitus, although more than half of men do not remember a specific traumatic event," says Culley C. Carson III, MD, Rhodes Distinguished Professor at the University of North Carolina School of Medicine and the chief of urology for University of North Carolina Hospitals in Chapel Hill, North Carolina.
Getting a Diagnosis
A physical examination may reveal a scar tissue plaque of the erectile body—even when the penis is limp. To determine the severity of the condition, an exam will require evaluation of erection. An ultrasound is usually ordered to evaluate blood flow and identify plaque.
What Are the Symptoms?
Penile curvature is the most common symptom, although it can be accompanied by erectile dysfunction (ED), painful intercourse, an "hour-glass" shape or indent in the penis, or no symptoms at all. In addition, Carson says it can also be associated with hypogonadism.
Beyond the physical pain of intercourse (for either partner), the disease may be emotionally traumatic for patients and their partners. Sure, it's a sensitive issue, but talking to your doctor is the first step in getting treatment.
It's also important to not delay getting help. Carson says his practice sees most men after they have had the condition for 6 to 18 months. But the earlier the condition is treated, the better the outcome.
If left untreated, about 40 percent of men will experience a progression of the disease; 47 percent will experience no change; and 13 percent will have a digression over time.
Treating Peyronie's Disease
"The goal of treatment is to restore function in men with the deformity," says Carson. For most men, that means medication. Only about 10 percent require surgery.
Medications:
Small studies have shown promise with vitamin E, but there are no controlled studies that show effectiveness for any of these medications.
- Oral medications, such as vitamin E, potassium aminobenzoate, pentoxifylline, tamoxifen, carnitine, colchicines, or L-arginine
- Topical treatments
Surgery:
Experts recommend waiting six months to one year before considering corrective surgery. There are three types of procedures:
- Plication. The curvature of the penis is altered (by removing or pinching a piece of the tunica albuginea opposite the plaque) to straighten the penis.
- Plaque Incision or Excision. This procedure removes plaque tissue and replaces it with a graft to straighten the penis.
- Prosthesis Implantation. For men with severe ED, an inflatable penile prosthesis is implanted to help increase rigidity.
Sources:
Culley C. Carson III, MD, Rhodes Distinguished Professor at the University of North Carolina School of Medicine and the chief of urology for University of North Carolina Hospitals in Chapel Hill, North Carolina. http://www.Menshealthpd.com
U.S. Department of Health and Human Services
National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC)
Peyronie's Disease http://kidney.niddk.nih.gov/kudiseases/pubs/peyronie/index.aspx
