PEYRONIE'S DISEASE
Peyronie’s disease involves the development of fibrous (hard) tissue on the penis, causing penile curvature and pain during erection.
Incidence
The disease affects approximately 3-9% of the male population.
Risk Factors
Though the following factors have been reported, their association with Peyronie’s disease is not clear-cut:
- Diabetes mellitus
- Alcoholism
- Hyperlipidemia
- Hypertension
- Smoking
- Ischemic heart disease
- Erectile dysfunction
Causes
The most common cause is penile microtrauma (minor injury) during sexual intercourse.
In men with one or more risk factors, normal restoration of the damage is not feasible, resulting in the formation of a hard scar.
The scar constricts the layer of the penis (tunica albuginea) and makes it bend towards the side of the scar.
Symptoms
The main symptoms of the disease are:
- Localized pain
- Palpable hard lumps on the penile shaft
- Upwards penile curvature (bending) during erection, oriented to the right or to the left
Symptoms vary depending on the stage of the disease.
At an early stage, the penis hurts when erect, and the pain may go away without treatment.
At an advanced stage, the penis curves when erect and makes sexual intercourse difficult or even impossible.
Diagnosis
The following are needed:
- Medical history
- Sexual history
- Photo of the erect penis taken by the patient
- Clinical examination
- Penile ultrasound
- Triplex ultrasound of the penile vessels, assisted by drug-induced erection
Treatment
When penile curvature inhibits sexual intercourse, treatment is needed.
At an early stage (before the plaque becomes permanent), the treatment plan involves medication, but it usually delivers moderate or poor results.
At a later stage, when the plaque is permanent, surgery constitutes the only treatment option.
There are several types of surgical procedures, subject to the degree of penile curvature, and the presence or absence of erectile dysfunction.