“May all be happy, may all be healed, may all be at peace and may no one ever suffer."
Peyronie's disease is a condition characterized by the development of a fibrous plaque, or scar tissue, in the penis. This plaque can cause the penis to curve or bend during an erection, leading to pain and difficulty with sexual intercourse.
The exact cause of Peyronie's disease is not fully understood, but it is thought to be related to repeated trauma or injury to the penis, which can cause inflammation and subsequent scarring. Other risk factors for Peyronie's disease include family history, certain medical conditions such as diabetes, and smoking.
Symptoms of Peyronie's disease may include pain during an erection, curvature or bending of the penis during an erection, and difficulty with sexual intercourse. In some cases, the curvature may worsen over time.
Treatment options for Peyronie's disease may include medication, such as collagenase injections or oral vitamin E, which can help reduce the size of the plaque and improve symptoms. In some cases, surgery may be necessary to correct the curvature of the penis. Your doctor can provide more information on the best treatment options for your individual case.
The cause of Peyronie's disease isn't completely understood, but a number of factors appear to be involved.
It's thought Peyronie's disease generally results from repeated injury to the penis. For example, the penis might be damaged during sex, athletic activity or as the result of an accident. However, most often, no specific trauma to the penis is recalled.
During the healing process after injury to the penis, scar tissue forms in a disorganized manner. This can lead to a nodule you can feel or development of curvature.
Each side of the penis contains a spongelike tube (corpus cavernosum) that contains many tiny blood vessels. Each of the corpora cavernosa is encased in a sheath of elastic tissue called the tunica albuginea (TOO-nih-kuh al-BYOO-JIN-e-uh), which stretches during an erection.
When you become sexually aroused, blood flow to these chambers increases. As the chambers fill with blood, the penis expands, straightens and stiffens into an erection.
In Peyronie's disease, when the penis becomes erect, the region with the scar tissue doesn't stretch, and the penis bends or becomes disfigured and possibly painful.
In some men, Peyronie's disease comes on gradually and doesn't seem to be related to an injury. Researchers are investigating whether Peyronie's disease might be linked to an inherited trait or certain health conditions.
Treatment recommendations for Peyronie's disease depend on how long it's been since you began having symptoms.
For the acute phase of the disease, treatments range from:
For the chronic phase of the disease, several potential treatments are available. They may be done alone or in combination:
Oral medications aren't recommended in the chronic phase, as they haven't been shown to be effective at this stage of the disease. Shock wave therapy, stem cells and platelet-rich plasma also haven't been shown to be effective in human studies.
A number of oral medications have been tried to treat Peyronie's disease, but they have not been shown to be effective consistently and are not as effective as surgery.
In some men, drugs injected directly into the penis might reduce curvature and pain associated with Peyronie's disease. Depending on the therapy, you might be given a local anesthetic to prevent pain during the injections.
If you have one of these treatments, you'll likely receive multiple injections over several months. Injection medications may also be used in combination with oral drugs or traction therapies.
Medications include:
Penile traction therapy involves stretching the penis with a self-applied mechanical device for a period of time to improve penile length, curvature and deformity.
Depending on the specific device, traction therapy may need to be worn for as little as 30 minutes to as much as three to eight hours a day to achieve benefits. The effectiveness of treatment may also depend on the specific device used.
Traction therapy is recommended in the early phase of Peyronie's disease. It's the only treatment shown to improve penile length. Traction therapy may also be used in the chronic phase of the disease, combined with other treatments or after surgery for a better outcome.
Your doctor might suggest surgery if the deformity of your penis is severe, sufficiently bothersome or prevents you from having sex. Surgery usually isn't recommended until you've had the condition for nine to 12 months and the curvature of your penis stops increasing and stabilizes for at least three to six months.
Common surgical methods include:
The type of surgery used will depend on your condition. Your doctor will consider the location of scar tissue, the severity of your symptoms and other factors. If you're uncircumcised, your doctor might recommend a circumcision during surgery.
Depending on the type of surgery you have, you might be able to go home from the hospital the same day or you might need to stay overnight. Your surgeon will advise you on how long you should wait before going back to work — generally, a few days. After surgery for Peyronie's disease, you'll need to wait four to eight weeks before sexual activity.
A technique known as iontophoresis uses an electric current to administer a combination of verapamil and a steroid noninvasively through the skin. Available research has shown conflicting results on penile curvature and erectile function.
Several nondrug treatments for Peyronie's disease are being investigated, but evidence is limited on how well they work and possible side effects. These include using intense sound waves to break up scar tissue (shock wave therapy), stem cells, platelet-rich plasma and radiation therapy.