What is Peyronie's disease?

Peyronie's disease results in the penis, when it is erect, becoming bent.

Whilst the cause of Peyronie's disease is not fully understood, the bend is caused by flat scar tissue or ‘plaques’ forming in the penis. The plaque actually builds up in the area of the penis called the tunica albuginea which is a thick elastic membrane which enables the penis to maintain its rigidity during an erection. The plaque can appear anywhere along the length of the penis and as it develops it will pull on the surrounding tissue which will result in the penis becoming bent, usually during an erection.

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It is not uncommon for penis’s to curve slightly when erect, either to the left or to the right but if the curved erection causes pain or makes intercourse difficult or even impossible, it may be that the condition is Peyronie's disease.

Peyronie's disease may have a tendency to run in families, that is, if your father or brother suffers from Peyronies disease it is more likely, you are more likely to suffer

Symptoms

Thickened area (plaque) in the shaft of the penis
In 70% of cases of Peyronie's disease, the plaque forms on the top of the penis where it will make this area of the tunica albuginea less flexible and so can cause the penis to bend upwards.

Whilst it is not common, some men may have more than one plaque which is likely to cause complex curves.

The penis may look misshapen
Pain in the penis during an erection (pain in the penis when it is flaccid is rare) but some people with the cognition do not experience pain. If the sufferer does experience pain it may lead to issues that result in erectile dysfunction
Loss of length or girth of the penis

Peyronie's disease is not uncommon and appears to occur in about 6% of men between 40 and 70 years of age but has also been seen in men as young as their thirties. We have to consider when we look at the estimated figures that the real figure may be considerably higher as a result of many cases going unreported

This disease can seriously affect the quality of a sufferer’s life. More than three-quarters of men who are suffering Peyronie's disease are stressed or depressed or both; sadly, many men with Peyronie's disease are too embarrassed to consult with their doctor and so end up suffering in silence.

However, we have seen an increase of reporting of Peyronies disease in recent years which may be a result of new medication for erectile dysfunction being available which in itself is likely to result in more men with Peyronie's disease coming forward

Causes

There are several possible causes for the formation of the plaques in Peyronie's disease:-

Trauma to the penis, as a result of vigorous sexual activity or non-sexual activity
Autoimmune disease. For example, systemic Lupus erythematosus which causes inflammation to a variety of body tissue including the joints, skin, heart, kidneys and brain.
Connective tissue disorders. For example, Dupuytren’s contracture is a disease associated with Peyronie's disease that affects the connective tissue which results in the tissue shortening and thickening. This in turn results in the fingers becoming bent. Although we do not know why it seems that men with Dupuytren’s contracture are more likely to develop Peyronie’s disease
The ageing process. The chances of developing PD as you get older as the tissue of the penis, should it be injured, is less likely to heal well

Treatment

While some men do not require treatment for the condition because the symptoms are not very severe, they do not experience pain and they do not have any problems with sexual intercourse. However, for other men there is quite a range of treatment which can be tried depending on how they are experiencing PD.

Surgical

Surgery can be carried out to remove plaque in order that the penis is not curved during an erection.

Alternatively a small section of the penis can be removed and so compensating for the effect of the plaque in the penis and causing it to straighten - this may result in the penis being slightly shorter

Finally, the urologist may consider implanting a device to straighten the penis

Urologists recommend that surgery should not be considered until there is the stability of plaque and so the bend.

Non-surgical

Injections

Injections directly into the plaque can be done in the acute phase of the disease

Oral medicines

Currently, there aren’t any medications available that have proved to be effective in straightening the penis

However, when the disease has had the effect of causing erectile dysfunction, it may be that the class of drugs known as PDE inhibitors which includes Viagra and Cialis for example, could be considered to aid with this particular issue