Peyronie’s disease in men and how to manage it

There is probably no other part of the male anatomy that men scrutinize the most than their penis.  If it is not perfectly straight when erect, a man may wonder is this normal or not.  To set the record, uh, straight, a slight curve or tendency to lean to the left or right when erect is considered normal.  But, if the penis has a significant bend that is more noticeable, then it could be a condition called Peyronie’s disease.

What is Peyronie’s disease?

Peyronie’s disease (also called penile curvature) is when scar tissue or plaque forms in the soft tissue of the penis.  This condition is rare in young men and is estimated to affect between 1 to 23 percent of men between ages 40 and 70, although some cases go unreported. A thick, elastic membrane called the tunica albuginea is where the plaque builds up inside the tissues of this membrane.  Either the top or bottom of the penis is the most common areas where plaque buildup occurs. 

The plaque that forms is not the same type of plaque that develops in a person’s arteries.  It not associated with heart disease, is noncancerous, noncontagious and is not caused by a sexually transmitted disease.

Symptoms of Peyronie’s disease

The symptoms associated with Peyronie’s disease can range from mild to severe developing either slowly or suddenly.  Symptoms of this condition include:

·      A curve in the penis when it is erect – usually it curves upward

·      A thickened area or hard lump, which is the plaque, in the shaft of the penis

·      Painful erections and sexual intercourse

·      A misshapen look to the penis, like an hourglass

·      Loss of length or girth of the penis

·      Erectile dysfunction

Causes of Peyronie’s disease

It is not completely understood what causes Peyronie’s disease.  Some possible reasons could include the following:

·      An injury to the penis such as being bent during sex.  Vigorous sex can cause microscopic tears to the penis

·      A chronic or repeated injury to the penis

·      Autoimmune disease in which the body’s immune system attacks certain areas of the body’s cells and organs

·      Aging

·      A family history of the disease 

Diagnosing and treating Peyronie’s disease

Any man who has Peyronie’s disease needs to discuss the problem with his doctor.  The longer he waits the greater chance for serious complications.  The complications can lead to not being able to have sexual intercourse, erectile dysfunction, anxiety and stress, and difficulty in fathering a child.

It is best if a man sees a urologist which will diagnosis Peyronie’s disease based on a man’s medical and family history, a thorough physical exam feeling the hardened tissue caused by the disease along with imaging tests. 

For many men, the disease changes over time, but it does not go away. It usually occurs in two phases: the acute or active phase, when the changes in the penis occur and the pain is most acute, and the chronic or stable phase, when the pain subsides substantially and changes cease to occur.  In rare cases, Peyronie’s disease resolve on its own within 12-18 months without any form of medical treatment.  

Treatment for Peyronie’s disease depends on how severe the condition is.  Some men don’t require any treatment if there is no pain and it is not affecting their sex life.  Non-surgical treatment options include medications and injections of steroids into the area affected. 

In more severe cases, it can be treated with surgery.  Generally a doctor will recommend waiting at least 12 months as the condition can improve on its own without surgery.  Surgery may involve removing or cutting away the plaque or implanting a device to straighten the penis. 

Other treatments that might help include: 

·      Oral medications

·      Therapies, such as radiation therapy, to break up scarring

·      Mechanical traction or vacuum devices

·      Nonsurgical prescription treatment in the form of an injection

The last thing a man who has Peyronie’s disease is to resort to using gimmicks or other harmful tactics to treat their condition. All men with this condition needs to seek out advice from a trained urologist who is familiar with Peyronie’s disease to get the best help available.