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Peyronie's Disease

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When a penis is erect, it may curve naturally, not causing any problems.  However, when such a curve results in difficulty and pain during intercourse, it may occur because plaque or scar develops within the penis and that condition is known as Peyronie's disease. 

What are the most common symptoms of Peyronie's Disease ?

  • Curvature that hinders intercourse
  • Painful erections
  • Erections that are not firm
  • Change in penis size or appearance, such as shortening or narrowing
  • Hardened area that can be felt beneath the penile skin where the plaque has formed.

What causes Peyronie's Disease ?
 Since no one knows for sure why this condition develops, the listing below contains only possible causes. We do know one thing for sure - Peyronie's disease is not caused by sexually transmitted diseases or cancer.

  • Result of injury to the erect penis or a strike to the groin
  • Problem with the immune system
  • Unknown reasons

How Peyronie's Disease is evaluated ?
Without a complete evaluation, determining a treatment for such a condition is impossible, therefore, the first step is to see your physician.  If possible, he will be able to identify the location, size and hardness of the plaque.  Be prepared to tell him exactly what your symptoms are and when they first began. 

What treatments are available ?
Since this disorder sometimes resolves itself without medical intervention, a conservative waiting period should be enforced before more invasive treatment is begun.  This should include relieving pain and straightening the penis enough to allow intercourse.  If the plaque gets progressively worse over this period of time, as it sometimes does, then another course of action will be taken.  As of yet, there is no single effective treatment, but rather a combination of treatments tailored for the individual that is most successful.  Consult your physician for the best options, which may include:

  • Medications - There are various types of medications that have proven effective to soften and reduce the size of the plaque.  Some are taken orally while others are used locally.  As with any medication, there may be side effects, which your physician will discuss with you.
  • Surgery - Used only in severe cases when medication has not proven to be successful.  This may involve removal of the plaque while replacing the tissue with a graft; shortening the penis slightly on one side to straighten the curve or using prosthesis to lessen the curve and add rigidity to the penis.

Peyronie’s disease is development of intracorporal fibrosis of the penis of unknown etiology. It frequently affects middle aged men. Hypothesis is that Microvascular trauma to  the corpora cavernosa of the penis results in  intracorporal bleeding which results in fibrous scar which limits the hemodynamics of penile erectile with angulation of the penis in different directions. Common clinical complications of intracorporal plaques, Peyronie’s disease results in abnormal angulations, sexual dysfunction, painful erections, shortening of penis, penile pain and dyspareunia.

Clinical examination reveals plaques in the dual corporal bodies along the penile ligaments and ultrasound is an imaging modality utilized for definitive diagnosis of peyronie’s disease. Ultrasound of the penis confirms localized echogenic plaques within the dorsal dual corpora cavernosa of the penis. Occasionally plaques may calcify confirmed by penile ultrasound.