Peyronie’s disease is a condition that affects the male penis causing the development of scar tissue in the tissues causing erections. It most commonly affects men aged 50-70, but can affect men of any age.
It was first described by French physician Francois de la Peyronie in 1743. However, it is likely that the condition has been present for much longer, as it is mentioned in ancient Greek and Roman literature.
It is not yet fully understood why this scar tissue forms, but is thought to occur from small repeated episodes of trauma to the penis during sexual intercourse. This trauma, along with abnormal healing of the damaged tissue causes scar tissue to develop, called a “plaque”.
It is thought to be associated with diabetes, smoking and Dupuytren’s contracture (Credit: Science Photo Library). However, the majority of cases of Peyronie’s disease are called “idiopathic” meaning there is no particular cause.
The Science Behind Peyronie’s Disease
The main area affected in the penis is the tunica albuginea, the internal lining that surrounds the erectile tissue of the penis. Damage to this lining causes three main symptoms:
- Bending or curvature of the penis, especially when it is erect.
- Pain in the penis.
- Difficulty with erections.
The curvature is usually thought to occur over a period of 12 – 18 months. It may curve in any direction, and is considered severe if it is over 60o. You may also have other deformities in the penis such as indents or a ring-like scar around the penis leading to what is called a “waisting” deformity (because it looks like a human waist or a corset).
The period when the curve occurs is called the “Active phase” of the disease, where curvature may be progressive and may also cause pain in the penis. The pain may either be with erections or the plaque itself may be painful.
After the active phase, the condition will usually enter a stable phase or “Latent phase” where the pain begins to settle. During this period, the curvature will normally slow down. It is estimated that in this phase the curvature of the penis will stay the same in 48% of cases, worsen in 40% and rarely may improve (12%).
Erections are often normal during the progress of Peyronie’s disease, but may be affected adversely. Some men may require assistance with erections, with medications such as Viagra (Sildenafil) or Cialis (Tadalafil). It is safe and effective to take these medications, and will not cause worsening of the disease. In some cases it can also be beneficial to help improve blood flow to the erectile tissue and may rarely improve the curvature of the penis.
What to do if you think you have Peyronie’s Disease
If men are affected by Peyronie’s disease, the first thing is to stay calm. Peyronie’s disease is a slow growing process and unfortunately there is very little that can be done to prevent it or slow the progress. There are some good practices which have been researched and may show some benefit in the condition. However, the general advice from Urology Specialists (the medical specialists who deal with Peyronie’s disease), is that the condition must go through the active phase before any treatment is advised.
Historically, treatments for Peyronie’s disease were limited and often ineffective. Early treatments included the use of external devices to straighten the penis, such as weights or traction devices. In more severe cases, surgical interventions were used, but these often resulted in further complications and a poor outcome.
Now, with advancing technology and medical research, there are more effective treatments available for Peyronie’s disease. Medications, such as collagenase clostridium histolyticum, can be used to break down the scar tissue and improve the curvature of the penis, or injections such as verapamil or interferon alpha-2b may help. However, many of these treatments are not available in many countries, and they may not completely resolve the issue. Surgical interventions may still be necessary, but these have improved significantly over the years and now have a higher success rate.
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