Peyronie's Disease

Peyronie's Disease

Peyronie's disease is a noncancerous condition resulting from fibrous scar tissue that develops on the penis and causes curved, painful erections. Penises vary in shape and size, and having a curved erection isn't necessarily a cause for concern. But Peyronie's disease causes a significant bend or pain in some men.

This can prevent you from having sex or might make it difficult to get or maintain an erection (erectile dysfunction). For many men, Peyronie's disease also causes stress and anxiety. Penile shortening is another common concern.

Peyronie's disease rarely goes away on its own. In most men with Peyronie's disease, the condition will remain as is or worsen. Early treatment soon after developing the condition may keep it from getting worse or even improve symptoms. Even if you've had the condition for some time, treatment may help improve bothersome symptoms, such as pain, curvature and penile shortening.

How Does the Penis Normally Work?

The main roles of the penis are to carry urine out of the body and sperm into the woman's vagina. There are 3 tubes inside the penis. One is called the urethra. It's hollow and carries urine from the bladder through the penis to the outside. The other 2 tubes are called the corpora cavernosa. These are soft, spongy tubes that fill with blood to make the penis stiff during an erection. The 3 tubes are wrapped together by a very tough fibrous sheath called the tunica albuginea. During sex, the stiffness of the penis makes it hard enough to push into the woman's vagina. Then the urethra acts as a channel to carry semen into the vagina.

How Common is Peyronie's Disease?

Peyronie’s disease is thought to happen in about 6 out of 100 men between the ages of 40 and 70. It’s rare in young men, but has been seen in men in their 30s. The number of cases may be higher than the estimates because many men may be embarrassed and choose not to see their health care provider.

Interestingly, more Peyronie’s disease cases have been noted in recent years. This may be because new meds for erectile dysfunction (ED) have come to market, and health care providers may notice Peyronie’s disease in men seeking help for ED. For this reason, the number of Peyronie’s disease cases reported will likely keep growing.

Symptoms

The most common signs and symptoms include:

  • Scar tissue. The scar tissue associated with Peyronie's disease — called plaque but different from plaque that can build up in blood vessels — can be felt under the skin of the penis as flat lumps or a band of hard tissue.
  • A significant bend to the penis. Your penis might curve upward or downward or bend to one side.
  • Erection problems. Peyronie's disease might cause problems getting or maintaining an erection (erectile dysfunction). But, often men report erectile dysfunction before the beginning of Peyronie's disease symptoms.
  • Shortening of the penis.Your penis might become shorter as a result of Peyronie's disease.
  • Pain. You might have penile pain, with or without an erection.
  • Other penile deformity. In some men with Peyronie's disease, the erect penis might have narrowing, indentations or even an hourglass-like appearance, with a tight, narrow band around the shaft.

The curvature and penile shortening associated with Peyronie's disease might gradually worsen. At some point, however, the condition typically stabilizes after three to 12 months or MORE.

Pain during erections usually improves within one to two years, but the scar tissue, penile shortening and curvature often remain. In some men, both the curvature and pain associated with Peyronie's disease improve without treatment.

Stages of Peyronie's Disease

Peyronie's disease is often split into 2 stages: the acute phase and the chronic phase. During both phases, the bent/curved penis may cause problems with sex. You also may have ED.

Acute Phase: The acute phase lasts for 6 to 18 months. During this time, the plaques form in the penis, the bending/curving of the penis gets worse, and you may feel pain when your penis gets hard.

Chronic Phase: The chronic phase is when the plaque stops growing and the penis doesn't bend any further. If there was pain with erection during the acute phase, it often will have ended by this time.

Peyronie's Disease Causes

The cause of Peyronie's disease isn't completely understood, but a number of factors appear to be involved.

It's thought Peyronie's disease generally results from repeated injury to the penis. For example, the penis might be damaged during sex, athletic activity or as the result of an accident. However, most often, no specific trauma to the penis is recalled.

During the healing process after injury to the penis, scar tissue forms in a disorganized manner. This can lead to a nodule you can feel or development of curvature.

Each side of the penis contains a spongelike tube (corpus cavernosum) that contains many tiny blood vessels. Each of the corpora cavernosa is encased in a sheath of elastic tissue called the tunica albuginea , which stretches during an erection.

When you become sexually aroused, blood flow to these chambers increases. As the chambers fill with blood, the penis expands, straightens and stiffens into an erection.

In Peyronie's disease, when the penis becomes erect, the region with the scar tissue doesn't stretch, and the penis bends or becomes disfigured and possibly painful.

In some men, Peyronie's disease comes on gradually and doesn't seem to be related to an injury. Researchers are investigating whether Peyronie's disease might be linked to an inherited trait or certain health conditions.

Complications

Complications of Peyronie's disease might include:

  • Inability to have sexual intercourse
  • Difficulty achieving or maintaining an erection (erectile dysfunction)
  • Anxiety or stress about sexual abilities or the appearance of your penis
  • Stress on your relationship with your sexual partner
  • Difficulty fathering a child, because intercourse is difficult or impossible
  • Reduced penis length
  • Penile pain
Peyronie's Disease Diagnosis

A physical exam is often sufficient to identify the presence of scar tissue in the penis and diagnose Peyronie's disease. Rarely, other conditions cause similar symptoms and need to be ruled out.

Tests to diagnose Peyronie's disease and understand exactly what's causing your symptoms might include the following:

  • Physical exam. doctor will feel (palpate) your penis when it's not erect, to identify the location and amount of scar tissue. He or she might also measure the length of your penis. If the condition continues to worsen, this initial measurement helps determine whether the penis has shortened.
    doctor might also ask you to bring in photos of your erect penis taken at home. This can determine the degree of curvature, location of scar tissue or other details that might help identify the best treatment approach.
  • Other tests. Your doctor might order an ultrasound or other tests to examine your penis when it's erect. Before testing, you'll likely receive an injection directly into the penis that causes it to become erect
    Ultrasound is the most commonly used test for penis abnormalities. Ultrasound tests use sound waves to produce images of soft tissues. These tests can show the presence of scar tissue, blood flow to the penis and any other abnormalities.
When to see a doctor

See your doctor as soon as possible after you notice signs or symptoms of Peyronie's disease. Early treatment gives you the best chance to improve the condition — or prevent it from getting worse. If you've had the condition for some time, you may wish to see a doctor if the pain, curvature, length or other deformities bother you or your partner.

Treatment recommendations for Peyronie's disease depend on how long it's been since you began having symptoms.

  • Oral medications
  • shock wave therapy
  • Traction therapy
  • Surgery
  • Other
What you can do

Make a list ahead of time that you can share with your doctor. Your list should include:

  • Symptoms you're experiencing, including any that might seem unrelated to Peyronie's disease
  • Key personal information, including any major stresses or recent life changes
  • Medications that you're taking, including any vitamins or supplements
  • History of injury to the penis
  • Family history of Peyronie's disease, if any
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