Pulverizing Peyronie’s Disease
Your penis has a slight bend to it. You ignore it because a bend never killed anyone. Later, you notice a small pain when you have sex. You mention this to your partner and she suggests you may have Peyronie’s disease.
Peyronie’s disease is a condition where scar tissue causes the penis to curve or lose length or girth. In some cases, it may cause pain and prevent the man from having sex. Peyronie’s disease is noncancerous and it doesn’t affect fertility.
You may be able to feel the scar tissue through the skin or you may have pain in a specific part of the penis as the scar tissue forms. During an erection, the penis can bend up, down, or to the side depending on the location of the scar. Some men may have an indentation or hourglass appearance.
What happens is that there is a thickening in the connective tissues in the penis. The thickening is often in the form of plaque, which is clearly felt when the penis becomes engorged. The thick plaque restricts the ability of the penis to stretch, and as a result, when an erection occurs, the penis tends to curve toward the side of the plaque. The curvature can be mild or quite severe, and when severe, it can prevent intercourse. Other problems with Peyronie’s disease are pain, and less commonly, impotence.
The disease was named after Francois de LaPeyronie, a physician in the service of the French king Louis the 14th and was first described around the mid 1700s.
The cause of this unusual condition is unknown. Some believe it is caused by repeated minor trauma, such as may occur during intercourse. Others feel the condition is inherited and is in some way related to other conditions that cause thickening of fibrous tissue.
Most men don’t have perfectly straight erections. A slight curve doesn’t always mean Peyronie’s disease. Men who have had a curvature their entire lives do not have Peyronie’s disease.
The course of Peyronie’s disease is difficult to predict. In many men, it is quite mild and never causes much of a problem. In others, it can be very severe and debilitating.
Sometimes the condition corrects itself without treatment, and this happens often enough that some physicians counsel waiting one or two years before initiating treatment.
There are a variety of medical and surgical treatments for Peyronie’s disease. Treatment may include pentoxifylline, which is taken by mouth. This drug acts on the immune system to quiet inflammation and formation of scar tissue. You would take this drug with one of three other drugs: verapamil, interferon alpha-2b and collagenase. These drugs are injected directly into the scar tissue in the penis.
Other drugs and supplements may also be prescribed such as carnitine and vitamin E (sometimes with colchicine). They are taken by mouth. These therapies are not usually effective in men with moderate to severe curvature.
High intensity ultrasound and radiation therapy have been tried but there is little evidence that shows it’s effective.
If it doesn’t improve over the course of a year, and if it makes sexual intercourse difficult, corrective surgery might be an option. In a typical procedure, the inflamed or scarred tissue is removed from the penis. It is replaced by tissue taken from another part of the body (often the scrotum or forearm).
This surgery seems to work well. However, the penis remains mildly curved. In addition, sexual function or shortening of the penis doesn’t always improve following surgery. In some cases, surgery can cause erectile dysfunction. Surgeons can implant a penile prosthesis during surgery. In some men, a prosthesis alone is enough to straighten the curvature and improve sexual function.
Hopefully you are one of those people where Peyronie’s disease goes away on its own. But if you are in pain, you should contact your physician so she can refer you to a urologist. Remember this condition is very treatable and it doesn’t lead to serious illness.
