Peyronie’s Disease

Peyronie’s Disease Is a connective tissue disorder of the penis where a plaque of scar tissue is formed beneath the skin layer of penis. It leads to curvature of penis or deformities of the penis. Some patients might have discomfort or even pain during erection and also pain during sexual intercourse. This may induce a psychosexual disorder (feel scared of having sex) and even will lead to erectile dysfunction in severe conditions. 

Symptoms of Peyronie’s disease 

  • Bent penis 
  • Shortening of penis 
  • Penile pain during erection and sexual intercourse 
  • Erectile dysfunction 

Two distinct phases of Peyronie’s disease 

Active phase in which plaque remodelling occurs, associated with penile pain 

Stable phase in which the remodelling stops, may or may not present with pain with remarkably unchanged symptoms more than 3 months

Risk factors of Peyronie’s disease 

  • Hereditary – family disease 
  • Connective tissue disorder – a man who has Dupuytren’s disorder (a disease which a cordlike thickening across the palm that causes the fingers to pull inward 
  • Age – normally increase risk at the age 50s and above 
  • Obesity 
  • Smoking 
  • Diabetic mellitus 
  • History of severe trauma or continuous injury such as athletics 

Causes of Peyronie’s disease 

Is still unknown. But if the patient has history trauma or repeating injury normally due to sex, or something like athletic activity, it may lead to scar tissue formation and slowly develop and worsen the curvature of penis. 

Diagnosis of Peyronie’s disease 

Physical examination: normally a physician will examine by palpating the surrounding areas. The plaque may or may not be detectable. This depends on the size of the plaques. Physicians also may be able to observe the curvature of penis if it is obviously deflected. 

Ultrasound: to detect the penis abnormalities and also check for the blood flow of penis (to rule out the obstruction of blood flow

What are the treatments for Peyronie’s disease? 

Commonly there are no oral medication which is effective for the disease. 

Recommended treatment (topical injection): 

Steroid injection: It helps to break down the size of plaque

Collagenase: A medication called Xialex- Collagenase clostridium histolyticum which used to break down the scar tissue

Verapamil: A drug which is normally used to treat hypertension. It can be used to disrupt the production of collagen. 

Inteferon: A type of protein that disrupts the production of fibrous tissue and also breaks it down.

Extracorporeal Shockwave Therapy 

It is an invasive treatment. The treatment is conducted by a probe to shoot at the plaque area to reduce and break down the scar tissues. It might require three sessions or more to see the improvement. 

Surgical treatment 

  • Suturing (placating) the unaffected area.
  • Incision or excision and grafting 
  • Penile implants 

Other treatment 

Iontophoresis is a technique which is using the electric current to administer the combination of verapamil and steroid noninvasely through the skin. 

Platelet-rich plasma injection is also recommended for localised injection by promoting the regeneration of surrounding tissue and the reconstruction of new blood vessels to increase the blood flow of the penis. 

Complication of Peyronie’s disease 

  • Erectile dysfunction – a condition which the penis unable to fully erect 
  • Anxiety and stress disorder 
  • Family harmony due to unsatisfied sexual life 

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