Peyronie's disease is caused by scar tissue, called plaque,
which forms along the length of the penis. This plaque is not visible, and
depending on the severity of the condition, the plaque can cause the penis to
bend, making sexual intercourse difficult.
What causes Peyronie’s disease?
The cause of Peyronie’s disease is not entirely clear. Many
researchers believe the plaque of Peyronie's disease can develop following
trauma (hitting or bending) that causes tearing of the elastic coverings of the
corpora (erection chambers) inside the penis.
Other cases, which develop over time, may be genetically linked or inherited.
In addition, a number of medications list Peyronie's disease
as a possible side effect. Most are a type of drug called beta-blockers that are
often prescribed for people with heart conditions or high blood pressure. Other
drugs that have this listing are interferon, which is used to treat
multiple sclerosis, and Dilantin, an anti-seizure medicine. However, the chances
of developing Peyronie's disease from any of these medicines are very low and
there is no evidence that Peyronie’s disease is related to taking these drugs.
Who gets Peyronie's disease?
One study found Peyronie's disease occurring in 9% of men.
Although the disease occurs mostly in middle-aged men, younger and older men can
get it. In some cases, men who are related tend to develop Peyronie's disease,
suggesting that familial factors might make a man vulnerable to the disease.
What are the symptoms of Peyronie's disease?
Symptoms may develop slowly or appear overnight. When the
penis is soft, no problem can be seen. But, in severe cases, the hardened plaque
reduces flexibility, causing pain and forcing the penis to bend or arc during
erection. In most cases, the pain decreases over time, but the bend in
the penis can remain a problem. Occasionally, milder forms of the disease will
resolve without causing significant pain or permanent bending.
The plaque itself is benign, or noncancerous. 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
the top and bottom, leading to indentation and shortening of the penis. Some men
with Peyronie's disease develop scar tissue elsewhere in the body, such as on
the hand or foot.
How is Peyronie’s disease diagnosed?
First, your doctor will talk to you and ask you about any
circumstances, such as injury, that may have occurred prior to symptoms
appearing (although these symptoms are often absent in men with Peyronie's
disease). Your doctor can feel the hardened tissue caused by the disease on
examination. In some cases where the doctor's examination does not confirm Peyronie’s disease, or in cases where the condition
develops rapidly, your doctor may perform a biopsy. A biopsy involves removing tissue from the affected
area for examination in a lab.
Can Peyronie’s disease be treated?
Yes. But, since some people's condition improves without
treatment, doctors often suggest waiting 1 to 2 years or longer before
attempting to correct it. Mild cases of the condition rarely require treatment.
If treatment is needed, surgery can be performed. The two most
common surgeries used to treat Peyronie's disease are:
- Removal of the plaque, followed by placement of a tissue patch
- Removal or pinching of tissue from the side of
the penis opposite the plaque, which counters the disease’s bending effect. This procedure is known as plication.
Unfortunately, the surgeries do not guarantee normal penis
function. The first method can involve partial loss of erectile function,
especially rigidity. The second method, known as the Nesbit procedure, causes a
shortening of the erect penis.
Most types of surgery produce positive results. But because
complications can occur, and because many of the complications associated with
Peyronie's disease (for example, shortening of the penis) cannot be corrected by
surgery, most doctors prefer to perform surgery only on the small number of men
with curvature so severe that it prevents sexual intercourse.
If surgery is not right for you, there are other options. Some
studies have suggested that vitamin E pills improve Peyronie’s disease. Similar
inconclusive studies have been done on para-aminobenzoate, a substance related
to B-complex vitamins. In certain instances, the calcium channel blocker verapamil
has been suggested as being effective in decreasing the pain related to Peyronie’s disease when
injected directly into the penile scar or plaque.
Other approaches to treating Peyronie’s disease that have
yet to be confirmed as effective include the injection of chemical agents
directly into the plaque, or radiation therapy. But radiation therapy can only
relieve pain associated with Peyronie’s disease; it cannot cure it.
Since the severity of the condition varies from person to
person, talk to your doctor about what treatment strategy is right for you. The
pain associated with Peyronie’s disease is usually mild and thus not treated.
This pain occurs only with an erection.
What is the outlook?
Peyronie’s disease is a self-limiting condition. Pain
disappears with time, plaque formation stops, and the erection deformity
stabilizes. Most men with Peyronie’s disease are able to have sexual
intercourse and for these men, surgical treatment is usually not necessary.
Peyronie’s disease. National Kidney and Urologic Diseases Information Clearinghouse.
kidney.niddk.nih.gov. Accessed 4/15/2011.
What I need to know about erection problems. National Kidney and Urologic Diseases Information Clearinghouse.
kidney.niddk.nih.gov. Accessed 4/15/2011.
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