WHAT IS PEYRONIE’S DISEASE

Every penis is unique, with differences in length, girth, color, and even curvature.

It’s important to know that most erections aren’t perfectly straight. Many men naturally have a slight bend in their penis. These minor curvatures are common and typically not a cause for concern since they don’t cause pain or affect sexual health.

Peyronie’s disease is different from these normal variations, however, as it can severely impact your ability to engage in sexual activity.

The penis contains two sponge-like tubes called corpora cavernosa, surrounded by a stretchy tissue called the tunica albuginea. When you become sexually aroused, blood flows into these chambers, causing your penis to expand, straighten, and stiffen.

With this disease, scar tissue forms within the penis, preventing it from stretching normally and causing a pronounced bend or change in shape during an erection, often accompanied by pain.

Symptoms can develop gradually or appear suddenly. You might notice:

• A distinct bend or curve in your penis, particularly during an erection
• The formation of a hard lump or plaque on one or more sides
• Pain during erections
• Pain during sexual activity
• Difficulty with sexual intercourse due to the curvature or pain
• A decrease in the length or girth of your penis
• Erectile dysfunction (ED): difficulty achieving or maintaining an erection

The exact cause isn’t fully understood, but it’s thought to be related to trauma or injury to the penis that leads to abnormal healing. Some risk factors that may increase your chances of developing Peyronie’s disease include:

• Age- It’s more common in men over 40
• Connective tissue disorders like Dupuytren’s contracture, which affect connective tissue throughout your body
• Genetics or family history
• Other underlying health issues like diabetes

To diagnose Peyronie’s disease, your doctor will review your medical history and likely perform a physical examination to feel for plaques in your penis. In some cases, imaging tests like ultrasound are used to:

• Evaluate the severity of the curvature
• Check blood flow to the penis
• Assess the presence of scar tissue

Treatment depends on how long you’ve had symptoms.

Scar tissue forms during the acute phase of Peyronie’s disease, which can last from 5 to 18 months. This can cause the curvature to worsen or lead to changes in length. You might also experience pain during erections. At this stage, treatment options to help manage your symptoms include:

• Penile traction therapy. This non-invasive method involves using a device that gently stretches your penis to counteract the curvature and prevent shortening. It’s most effective when started early.
• Medication. The FDA-approved injectable treatment collagenase clostridium histolyticum (Xiaflex) has shown promising results for Peyronie’s disease. Xiaflex works by targeting scar tissue directly, which can help reduce the curvature of the penis in many cases. When combined with other therapies, such as penile traction, Xiaflex has demonstrated better outcomes, reducing curvature and maintaining penile length, compared to using other treatments alone.

In the chronic phase of Peyronie’s disease, the scar tissue in your penis stops growing, and your symptoms stabilize. During this stage, you typically no longer experience penile pain, and there are no further changes in the curvature or length. This phase occurs later in the disease, after the initial period when most changes and discomfort occur.

If you’re in the chronic phase of Peyronie’s disease, treatment options include:

• Watchful waiting. Your urologist will keep an eye on your condition and step in with treatment if your symptoms start to get worse.
• Injections directly into the scar tissue to help reduce the curvature
• Traction therapy

Surgery for Peyronie’s disease is usually considered when other treatments like medications or traction therapy haven’t worked, and the curvature is severe enough to interfere with sexual function. It’s typically recommended after the condition has been stable for 9 to 12 months, meaning the curvature isn’t getting worse and the pain has subsided.

The main surgical options are:

• Plication surgery. Stitches are placed on the longer side of the penis to straighten it. This procedure is generally used for less severe curvature.
• Grafting. Some of the scar tissue is cut or removed, and a graft is used to cover the area. Grafting can help straighten the penis but has a higher risk of complications like erectile dysfunction.
• Penile implants. If you also have erectile dysfunction, penile implants can help help maintain an erection and straighten the penis.

1. How does Peyronie’s disease affect the appearance of the penis?

Peyronie’s disease often causes noticeable changes in your penis, such as a significant bend or curve, hard lumps under the skin, or an hourglass shape. You might also notice changes in the length or girth, especially during an erection.

2. Is Peyronie’s disease linked to other health problems?

While Peyronie’s disease isn’t life-threatening, it can be associated with other health conditions like diabetes or connective tissue disorders.