Peyronie’s disease is a connective tissue disorder that affects the male sex organ. The characteristics of this disease are not unlike Dupuytren’s contracture of the hand. Symptoms of Peyronie’s disease are grouped into three main characteristics — painful erections, bent erections, and palpable penile plaque.
Though it lacks public awareness, Peyronie’s disease is quite common, with about 1 in 11 men suffering from it.
What Causes Peyronie’s Disease?
The common denominator between men with Peyronie's disease is the presence of scar tissue. It is thought that some form of mild penile trauma causes the disease. Though some men with the disease may not recall such an injury, vigorous sex is a common cause for mild penile trauma.
The three main characteristics of Peyronie’s disease can be linked to this point of trauma. The bent erections are due to the scar tissue from the injury, which does not stretch as well as regular tissue. This scar tissue is comprised of collagen, which can harden to the thickness of bone.
While most men with Peyronie’s disease report an upward bend of the penis, it has also been observed that some men experience bends in other directions, complex bends, divots in the sides of the penis, and even hourglass deformations. This palpable plaque is actual scar tissue that has been deposited on the outer erectile bodies of the penis. In severe cases, this plaque becomes calcified.
The painful erections that some men with Peyronie’s disease experience are thought to be from inflammation in the plaque and typically disappear on their own in about 12 months.
It is not certain whether or not erectile dysfunction is caused by Peyronie’s, but this can sometimes be the case. Most men with Peyronie’s report normal erectile function, but some report difficulty maintaining an erection — likely due to leaky veins in the penis. Peyronie’s does not typically affect the tissue within the erectile bodies, but it can affect the veins surrounding them and prevent them from closing properly.
How Do You Treat Peyronie’s Disease?
Peyronie’s Disease is unique in that spontaneous resolution is not at all uncommon. Typically, the disease has a sudden onset followed by quick progression and stabilization. If the disease has been stable for less than six months, it may spontaneously resolve itself even if it appears to be worsening.
Most of the management of Peyronie’s depends on the extent of the disease’s stabilization, the severity of the defect, and the functionality of erection. Except for anti-inflammatory agents, medical therapy for Peyronie’s disease is no longer recommended by the American Urological Association.
A doctor may implement surgical therapy if the penile deformity has been stable for more than six months and prevents sexual relations. Penile-straightening surgery is a standard and simple operation that may be a viable option for men suffering from Peyronie’s disease. However, the exact method of straightening the penis will vary from patient to patient and depend on the curvature's severity.
Penile-straightening surgery does not come without complications, unfortunately. These complications include suture knots in the penis, numbness, penile shortening, and worsening erectile dysfunction. These complications (outside of penile shortening, which is not perceptible in most men) are rare.
For men with penile curvature greater than 90 degrees and erection loss that is unresponsive to medical therapy, a doctor may recommend penile prosthesis surgery. This surgery is considered somewhat of a last resort if the condition is unlikely to resolve itself. Many patients who receive this surgery choose an inflatable hydraulic implant in the erection chambers, allowing them to inflate their penis to achieve an erection whenever they want.
Understanding the symptoms and treatments of Peyronie’s disease can be key in catching otherwise unnoticed characteristics in the penis that could lead to further issues. Schedule an appointment with us today to stay on top of your urological health!