Peyronie’s disease is where segments of scar tissue form under the penis, causing bending or pain during erections. Peyronie’s disease is thought to happen in about 6 out of 100 men between the ages of 40 and 70.
How Does the Penis Normally Work?
The main roles of the penis are to carry urine out of the body and sperm into the woman’s vagina.
There are 3 tubes inside the penis. One is called the urethra for urine. The other 2 tubes are called the corpora cavernosa which fill with blood to create an erection.
What are Signs of Peyronie’s Disease?
Signs that you may have Peyronie’s disease are:
- bent/curved penis
- lumps in the penis
- painful erections
- soft erections
- having trouble with sex because of a bent/curved penis
What Causes Peyronie’s Disease?
Peyronie’s disease is likely caused by minor injury to the penis, most often caused by vigorous sex but also from sports or other accidents. Peyronie’s disease is the result of a problem in the way the body heals wounds. Men with certain connective tissue disorders (such as Dupuytren’s contractures) and men who have a close family member with Peyronie’s disease have a greater risk of getting it.
Stages of Peyronie’s Disease
Peyronie’s disease is often split into 2 stages: the acute phase and the chronic phase.
Acute Phase: The acute phase lasts for 6 to 18 months. During this time, the plaques form in the penis, the bending/curving of the penis gets worse, and you may feel pain when your penis gets hard.
Chronic Phase: The chronic phase is when the plaque stops growing and the penis doesn’t bend any further. If there was pain with erection during the acute phase, it often will have ended by this time.
How is Peyronie’s Disease Diagnosed?
The hard plaques can most often be felt whether the penis is stiff or not. To check how the penis curves, you may undergo a penile ultrasound and receive a penile injection to make it stiff.
How is Peyronie’s Disease Treated?
Men with small plaques, not much curving of the penis, no pain, and no problems with sex may not need to be treated.
There haven’t been enough studies to tell exactly how well or if these drugs work better than no treatment. Examples include Vitamin E, Potaba, Tamoxifen, and Colchicine.
Plaque injection is often used for men with acute phase disease who aren’t sure they want to have surgery. These include Verapamil, Interferon, and Collagenase injections.
Studies have shown that injecting collagenase into plaques helped fix Peyronie’s disease. This drug (Xiaflex®) is now approved in the U.S. for treatment of men with penises curving more than 30 degrees. Additional treatments include penile stretching and modeling.
Surgery for Peyronie’s Disease
Surgery is reserved for men with severe, disabling penile deformities that make it hard to have sex. Surgery is held until the curvature and pain have stabilized for at least 9 to 12 months.
There are 3 basic ways to fix Peyronie’s disease with surgery:
- making the side of the penis opposite the plaque shorter (plication)
- making the side of the penis that curves longer (grafting)
- placing a prosthetic device inside the penis