Peyronie's disease: this is defined as the development of fibrous scar tissue located in the inner part of the penis which results in curved and painful erections. The penis differs in shape and size, and the curved erection is not necessarily a cause for concern. But Peyronie's disease leads to a curved penis, rather than straight, erectile penis. This can lead to erectile dysfunction (inability to achieve or maintain an erection) and can also prevent affected individual from having sex. Stress and anxiety in most men are caused as a result of Peyronie's disease.
Peyronie's disease sometimes disappears on its own i.e. without treatment. But in most cases, it will remain stable or worse. Treatment may be necessary if the curvature is severe enough to prevent a successful sexual relationship. Majority of men that have Peyronie's disease can still have sex. But for some, it can be painful and results in erectile dysfunction.
Causes of Peyronie's disease
The exact cause of Peyronie's disease is not fully understood, but a number of factors seem to be involved. Peyronie's disease is thought to be the result of repeated penis injury. For example, a penis can be damaged during sex intercourse, sports activities or as a result of an accident. However, most of the times, no specific trauma to the penis has been recorded.
Symptoms of Peyronie's disease
Signs and symptoms of Peyronie's disease may suddenly appear or gradually develop. Below are the common signs and symptoms of Peyronie's disease:
- Scar tissue. The effect of the scar tissue known as plaques associated with Peyronie's disease can be felt under the skin of the penis in the form of flat lumps or a band of hard tissue.
- A noteworthy bend to the penis. Your penis can be bent in different directions, curved upward, downward or bent to one side. There can be narrowing, indentations or an hourglass appearance, with a tight, narrow band around the shaft on the erectile penis and this occurs in the majority of cases related to Peyronie's disease.
- Problems related to erection. Peyronie's disease can cause problems in obtaining or maintaining an erection. This is referred to as erectile dysfunction.
- Reduction of the penis size. There can be a reduction in the size of the penis making it become shorter due to the effect of Peyronie's disease.
- Pain. There can be a pain on the penis either with or without an erection.
When to visit a doctor
Consult a doctor if your pain or curvature of your penis stops you from having sex or causes anxiety.
Risk factors for Peyronie's disease
It seems that genetics and age play a role in Peyronie's disease. Changes in tissue can lead to minor injuries and slower healing in older men. This places them at a higher risk of developing the disease.
Men who have connective tissue disorder known as Dupuytren’s contracture have a greater chance of developing Peyronie's disease. Dupuytren's contracture is a thickening that appears in the hand and that pushes your fingers inward.
Complications of Peyronie's disease may include:
- Inability to have sex
- Difficulty in achieving or maintaining an erection (erectile dysfunction)
- Anxiety or stress about sexual ability or the look of your penis
- stress your relationship with your sexual partner
- Difficulties in producing a child as sex is either difficult or impossible
How do doctors diagnose Peyronie's disease?
Discuss with your doctor about anything that has happened, such as an injury, before the occurrence of the symptoms.
You will be examined by your doctor, which your doctor will feel the hardened tissue which is caused by the disease during the examination. It is not always important, but in case the penis needs to stand erect for examination, the doctor will inject the medicine to make it happen. There may be need to do an X-ray or ultrasound of the penis.
This is not common, but in many cases when the medical examination failed to confirm the presence of Peyronie's disease, or if the disease develops rapidly, your doctor may make a biopsy. This involves the removal of some tissue from the affected area for laboratory testing.
Can Peyronie's disease be treated?
Yes, but maybe you do not need it. Without treatment, Peyronie's disease may improve in some men and doctors often suggest that affected men should exercise patient for a period of 1 to 2 years or more before trying to solve the problem. Mild cases of the disease rarely require treatment. In addition, the pain that comes from Peyronie's disease appears only with an erection and is usually mild. If that does not cause a problem with your sexual life, treatment may be optional.
What are the available treatments?
The available treatment options include medication and surgery.
In there is a need for you to be treated, surgery or medication will be considered by your doctor? At first, it is possible that you are given prescription drugs by your doctor examples of such drugs are pentoxifylline or potassium-para-aminobenzoate (Potaba). In case these ones do not work, you can be given another option such as verapamil or collagenase (Xiaflex) injection into the penis tissue scar.
Peyronie disease Surgery
Surgery is the last line of action for severe penile deformity. Before you opt in for surgery as a way of treating Peyronie's disease, you should be patient for least a year according to NKUDC. Surgical solutions include:
- shortening the unaffected side
- lengthening the scar tissue side
- penile implants
Lengthening runs a greater risk of erectile dysfunction. Shortening the unaffected side is used when curvature is not that severe. There are some types of shortening procedure and one of them is referred to as the Nesbit plication. This procedure involves removal or cinch excess tissue on the longer side by the doctor. In the end, the outcome is the formation of a straighter, shorter penis
Many homegrown remedies for Peyronie's disease have not been well studied and based on anecdotal evidence. Some medications are studied and promising.
Acetyl-L-carnitine "was significantly more effective and safe when compared with tamoxifen in the treatment of acute and early chronic Peyronie’s disease." This is based on a conclusion by a 2001 study published in BJU International. No further research was conducted.
The results of a study published in 2010 in the International Journal of Impotence Research have shown that coenzyme additives Q10 improve the erectile function. It was also reported that this coenzyme additive Q10 also reduced penile curvature in patients that have chronic Peyronie's disease. More study is required on this.
Vitamin E is widely studied for the treatment of Peyronie's disease according to an article which was published in Reviews in Urology. Recent studies have shown that there is no improvement in vitamin E-treated patients compared with placebo.
Talking to your partner
This type of anxiety can result in having problems with your sexual partner.
Take steps to relieve stress in buds. Discuss with your partner about Peyronie's disease and how it affects your bed performance. If necessary, seek the help of your doctor or therapist to help you cope.
How to prepare for your appointment
If you have symptoms of Peyronie's disease, you should start meeting with a family doctor or general practitioner. You may be referred to an expert in male sexual disorders (urology). Preparation for an appointment will assist you in making the best use of your time.
What you can do?
Make a predetermined list that you can share with your doctor. Your list should include:
- Symptoms that you have, including those that may seem unrelated to Peyronie's disease
- Key personal information, including major constraints or recent changes in your life
- The medicines you are taking, including vitamins or supplements
- History of penis injury
- A family history of Peyronie's disease, if applicable
Questions to ask from your doctor
You might want to ask some of the following questions:
- What tests do I need?
- What kind of treatment do you recommend?
- Can you tell if symptoms can get worse or improve?
- Are there any brochures or other printed materials that can be brought home? Which websites do you recommend?
With questions you are willing to ask your doctor, do not hesitate to ask questions during the meeting.
What to expect of your doctor
Your doctor will probably ask you a few questions. Since you are ready to respond to them, you can give them time to review all the points you want to discuss in more detail. Your doctor may ask:
- When did you first notice the curve in the penis or scarring under the skin of the penis?
- Did your penis curve worsen over time?
- Do you have pain during erection, and if so, whether it has deteriorated or improved over time?
- Do you remember having injuries to your penis?
- Do the symptoms reduce your sexual ability?
Your doctor may also ask you to fill out a questionnaire, such as the International Index of Erectile Function, to help identify how the condition affects your ability to have sex.