Peyronie’s Disease

What is Peyronie’s Disease?

Peyronie’s disease is a connective tissue disorder of the penis where plaque/segments of scar tissue form under the skin of the penis. This plaque will lead to bend/curvature of the penis or penis becoming indented during erection. Some of the patients will encounter pain during erection which might lead to erectile dysfunction.

Symptoms of Peyronie’s Disease

Peyronie’s disease plaques mostly form on dorsal side or top of penis. The plaques make penis less flexible and will cause penis to bend upwards, downwards or sideways during erection.

The most common signs and symptoms include:

  • Bent penis
  • Erection problem
  • Shortening of penis
  • Penile pain
  • Penile deformity: tight, narrow, indented penis during erection

What are the stages of Peyronie’s Disease?

  • Acute stage: Last from 6 months to 1 year. Scar forms under the skin of penis during this period of time and will cause curvature or change in its shape. Usually, you will feel pain during acute phase.
  • Chronic stage: The penis curvature won’t worsening during this stage as the scar has stopped growing at this phase. The pain usually goes away by this time but some patients still have pain especially during erections.

Risk Factor of Peyronie’s Disease

  • Age: Peyronie’s disease can occur in men of any age group but the prevalence increases with age. So, it is more common to see in middle-aged group.
  • Genetic/Hereditary
  • Connective Tissue Disorders: Those who have underlying connective tissue disorder is more likely to have Peyronie’s disease.
  • History of undergone prostate surgery
  • Smoking
  • Autoimmune disorders

How to diagnose Peyronie’s Disease?

Usually, a doctor is able to diagnose Peyronie’s disease by physical examination. The hard plaques are able to feel with or without an erection. No blood tests are needed unless certain circumstances. Ultrasound will be done to see any scar tissue, presence of blood flow to the penis and to look for other abnormalities.

What are the treatments for Peyronie’s Disease?

Treatment of Peyronie’s disease will be based on the stages of the disease.

Acute Stage

  • Oral medications: Vitamin E, Tamoxifen, Colchicine, Potassium amino-benzoate
    • According to study, oral medications are not very effective in treating Peyronie’s disease
  • Injections:
    • Steroid: It help to break down the scar tissue and improve the penis curvature
    • Botulinum/Botox
    • Collagenase: It will help to break down scar tissue as well
    • Verapamil
    • Interferon: It slow down the rate of scar tissue formation and reduce swelling.
  • Extracorporeal Shockwave Therapy (ESWT)
    • This is a non-invasive treatment method.
    • ESWT will break down the scar tissue and help in new cell formation.
    • Suggest to do at least 3-5 sessions for better outcome
  • Penile traction therapy: recommend for early phase of Peyronie’s disease

Chronic Stage

  • Usually, if a man with Peyronie’s disease that longer than 12 months or this disease has affected men sexual activity, then surgical option will be recommended.
  • Common surgical methods:
    • Shortening the unaffected side: the unaffected/longer side of the penis will be suture to straightening the penis.
    • Incision/excision and grafting: Cuts will be made on the scar tissue to allow the sheath to stretch out and penis to straighten. A graft will be suture on place to cover the holes created by cuts. The graft will make the affected side become longer.
    • Penile implants: An implant will be inserted to allow blood to flow through and make erection stiffer.

Complications of Peyronie’s Disease:

  • Inability to get erection due to painful erection, this might lead to erectile dysfunction
  • Anxiety/stress about appearance of penis and sexual abilities
  • Relationship problem with partner due to unsatisfied sexual life
  • Unable to fathering a child as intercourse is impossible due to painful erection
  • Reduce penile length

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