Peyronie’s Disease: Causes, Symptoms and Treatment

Hand holding a bent cucumber, mimicking the effects of Peyronie's disease.

What Is Peyronie’s Disease?

Peyronie’s disease is a condition where scar tissue (or plaque) forms within the penis, which causes the penis to become curved during an erection rather than straight.

The majority of men with Peyronie’s disease are still able to have sex. However, for some men the condition can be painful and can also lead to ED (erectile dysfunction).

You may or may not opt to have treatment based upon your symptoms. Treatments can include medication, surgical procedures, and penile traction devices.

Peyronie’s Disease Causes

The exact cause for Peyronie disease is not known. Research suggests fibrous plaque may develop following injury, which causes bleeding within the penis. It is possible that the injury itself may even go unnoticed.

In some cases where the condition develops gradually, the cause may be due to genetic reasons. In other situations, the problem could be a result of both injury and genetic causes.

Peyronie’s Disease is also listed as a potential side effect of some prescription drugs. However, there is no evidence that these medications can lead to this condition.

Who Is At Risk for Peyronie’s Disease?

This condition is most common in middle-aged men, but it can occur in men at any age. However, it is not a normal part of the aging process, even though it is associated more with older men.

Symptoms of Peyronie’s Disease

Symptoms might occur gradually or happen suddenly, even overnight. If the penis is not erect, it’s difficult to tell that there’s a problem. However, during an erection there will be a noticeable curve in the penis due to hardened plaque. In severe cases, there can also be pain because of restricted flexibility of the penis.

For most men with Peyronie’s disease who experience pain or discomfort, the sensation will usually subside gradually as the penile inflammation decreases. However, this could take as long as 6-18 months. It is also possible for the bend in the penis to become worse.

The condition is also sometimes found in men who have scar tissue that develops elsewhere in the body. Additionally, Peyronie’s is more common in men who have Dupuytren’s contractures, which is a type of scarring affecting the fingers.

When To See A Doctor

Talk to your doctor about any trauma, injury or other possibly-related circumstances that may have occurred before you started experiencing symptoms.

During your visit, the doctor will feel examine your penis and feel for any hardened tissue. While not always required, if your doctor believes that the penis will need to be erect to better perform the examination, they will administer a medication to do so. It may also be necessary to perform an ultrasound or X-ray of your penis.

In rare instances, your doctor may need to perform a biopsy. This may happen if the doctor can not confirm a diagnosis of Peyronie’s for certain, or in cases where the condition occurred suddenly.

A biopsy involves removing a small amount of plaque cells from the penis. These cells are then examined under a microscope in order to diagnose the condition and to rule out any other medical problems.

Treatement For Peyronie’s Disease

There are options available for treating Peyronie’s disease. However, for some men it might not be necessary.

Some men will see improvement of their condition without any treatment. Doctors commonly recommend waiting for 1-2 years or more before seeking medical treatment.

The condition is rarely treated at all in less severe cases. Additionally, any pain associated with Peyronie’s disease occurs only during an erection and is typically mild. As long as the condition is not causing difficulties with your sex life, no treatment may be needed.

Medical Treatment

Your doctor may recommend medication or surgery if it turns out that treatment is necessary.

Medication

Initially, your doctor will likely prescribe pills for you to take, such as potassium para-aminobenzoate or pentoxifylline.

If that doesn’t work, your doctor may then suggest administering a series of injections of verapamil or collagenase directly in the scar tissue within the penis.

Surgery

Your doctor may recommend surgery if all else fails. This option is usually only reserved for men with Peyronie’s disease who are unable to have sex due to their condition.

There are generally two ways to surgically correct Peyronie’s disease:

  • Plaque Incision and Grafting – Plaque incision and grafting (or Lue procedure) involves pulling back the skin of the penis and  cutting into the scar tissue, pulling the penis straight, and then stitching a graft into the area. This restores and lengthens the concave side of the penis to match the longer, convex side.
  • Penile plication – Penile plication (or Nesbit procedure) involves using stitches to tighten the side of the penis opposite of the bend in order to straighten the penis. The stitching is generally done through a small incision along the side of the penis.

These treatments are not guaranteed to work, however. The plaque removal procedure can potentially cause erection issues, while the Nesbit procedure will likely reduce the length of the erect penis.

It may be possible to receive a penile implant in certain circumstances. This would primarily be used for men having both Peyronie’s disease and erectile dysfunction.

Although most surgical treatments can help, many doctors prefer to only operate on those men with curvature severe enough to prevent them from having sex. This is because there is a possibility for complications with these procedures that can’t be reversed.

Penile Traction Therapy

Penile traction therapy (PTT) is a relatively newer form of therapeutic option for men with Peyronie’s disease. It has long been used for the treatment of other conditions involving bone, skin, skeletal muscle, and for treating Dupuytren’s contractures.

Also known as penile traction devices, or penis extenders, these devices gradually expand the penile tissue by traction, resulting in the formation of new collagen tissue through cytokinesis (the dividing and formation of new cells). After prolonged use, the continuous stretching of the fibrous plaque results in substantial softening and lengthening of the scar tissue.

A number of clinical papers have shown promising results from the use of penile traction devices by Peyronie’s patients, and research indicates that their use significantly increases penis length and the improvement of penile curvature.(1)

PTT is a minimally invasive alternative treatment option to penile surgery in men with Peyronie’s. Penile traction therapy provides a minimally invasive method to effectively and permanently straighten and lengthen the penis.

Other Treatment Options

Research for treating Peyronie’s involving the use of vitamin E and potassium aminobenzoate (which is similar to folic acid) has shown mixed results. However, they have not been proven to be effective in curing the condition.

Unproven treatments for Peyronie’s disease include injections of chemicals directly into the plaque or radiation therapy. Radiation therapy is rarely used because it can only relieve pain caused by Peyronie’s disease, and often the pain returns after stopping treatment.


References:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4893512/
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