When scar tissue or inflammation develops under the skin of the penis due to trauma or minor injury, Peyronie’s (PAY-ROE-NEEZ) disease may occur. This can result in the penis becoming bent or indented during an erection, which can cause increasing pain or difficulty with intercourse.
Symptoms and Causes of Peyronie’s Disease
Because Peyronie’s disease will be have effects that are both tangible and visible, the symptoms are commonly noticeable to the naked eye. In over 70% of cases, the scar tissue will develop on the top of the penis causing it to bend upwards during an erection. If the scar tissues develops on the bottom or side of the penis, it will bend downward or sideways during an erection. In rare cases, the scar tissue may develop all around the penis, causing the shaft to narrow and become very hard.
If you are experiencing any of the following, you may be experiencing Peyronie’s disease:
- Pain during sex, or pain during an erection.
- Hard spots or lumps in the penis.
- Bends or curves in the penis.
- Narrowing or shortening of the penis.
Most often there is no obvious reason for the Peyronie’s disease, however it can be caused by injury to the penis due to sports athletic activity, aggressive sex, or an accident of some sort. However, there have been cases in which the disease is part of a larger autoimmune issue. If the disease attacks cells within the penis, it can lead to inflammation and scarring.
Because the chances of getting Peyronie’s disease increases with age due to changes in the elasticity of the penis, men over the age of 50 are more commonly affected. In addition, men with a more active sexual lifestyle that may cause injuries to the penis, or men who have a family history of Peyronie’s disease have a higher chance of developing it over their lifetime.
Diagnosis of Peyronie’s Disease
With or without an erection, Peyronie’s disease can most often be diagnosed in a physical exam. If scar tissue is felt, you may be given an injectable drug to create an erection and check how your penis curves or narrows. In addition, an ultrasound or X-ray may be ordered to get an accurate location of the buildup of scar tissue. This will allow for a proper treatment plan to be designed.
How is Peyronie’s Disease Treated?
The overall goal of treatment is to reduce pain and strengthen the ability to have intercourse. If you are not experiencing pain, and having very little issues with penile curvature, you may not need treatment until the symptoms progress. In a few cases, the disease will resolve itself without any treatment.
This can include decreasing the amount of vigorous sexual activity or aggressive sports and quitting any smoking, illegal drugs, or alcohol consumption.
Dr. Wierschem offers a variety of treatment options both surgical and non-surigcal. Each treatment is individualized based on the patient’s symptoms and degree of angulation.
- Medications: Vitamin E, Colchicine and Potaba
- Topical Verapamil cream
- Xiaflex® collagenase injections
If you are experiencing severe issues with penile curvature or pain, surgery may be recommended. The type of surgery will depend on the severity but could include any of the following:
- Suturing or “placating” the unaffected side
- This is a very effective treatment for mild to moderate cases. It is typically a 20-30 minute outpatient procedure with minimal discomfort. It may result in a minimal amount of penile shortening, however.
- Excision of plaque with grafting.
- This is a much more complex operation and usually utilized for severe cases.
- Placement of a penile implant
- This treatment is also used for more severe cases that are also associated with significant erectile dysfunction.