Peyronie’s Disease

Peyronie’s Disease is a penial problem caused by scar tissue called Plaque. The development of such fibrous scar tissue inside the penis can cause a curved and painful erection. At times the condition subsides with time, but in most cases, it remains stable or worsens.

Symptoms:

Peyronie’s disease plaque most often (70% of the time) occurs on the top (or the dorsal side) of the penis. Tunica Albuginea becomes less flexible due to the plaques and can cause the penis to bend when it stiffens. Apart from curving, these plaques can also cause narrowing of the penis like the neck of a bottle (called “bottle-necking”). In worse conditions, calcium may get deposited on the plaques making them very hard, just like a bone. Most men can also notice shortening or shrinkage in their penis size.

Other prominent symptoms of Peyronie’s Disease include:

  • Lumps in the penis
  • Curved/bent penis
  • Painful erection
  • Facing trouble while having sex due to curved/bent penis

How Common Is Peyronie's Disease?

It is rare in young men, but there were few cases observed among men in their 30s. It is frequent amongst older men and estimated to impact 6% of the men aged between 40 and 70. Most men suffering from Peyronie’s Disease can easily fall victim to depression and stress and are embarrassed about it and hesitant towards seeking medical attention required.

Causes:

Minor injury to penis is the most common reason for Peyronie’s Disease. Such injuries can be caused during vigorous sex (such as bending of penis during penetration or pressure applied from partner’s pubic bone) or during sports or other external activities.

Tissues known as Fibrosis, start forming in the cells because of injury to tunica albuginea and these scar tissues overtime form the plaques of Peyronie’s Disease.

Other factors that can cause Peyronie’s Disease are genes, environment, high blood sugar, tobacco use or previous pelvic trauma which result in wound healing problems. Men who have a family history of Peyronie’s Disease are at an increased risk of getting affected by this health condition. 

Men who have connective tissue disorders known as Dupuytren’s contractures can also suffer from Peyronie’s Disease.

Stages of Peyronie’s Disease:

Peyronie’s Disease can be classified into two stages:

Acute Phase:

  • Lasts from 6 to 18 months
  • Plaques form in the penis
  • Pain occurs during erection of penis
  • Bending/Curving of penis gets worse

Chronic Phrase:

  • Plaque stops growing
  • The penis does not bend further
  • If pain occurs during acute phrase, it is subsided by now

Diagnosis:

The medical professional can observe the presence of Peyronie’s Disease by physical exam. The plaques can be felt whether the penis is stiff or not. 

Dynamic Ultrasound, which captures pictures of what is inside your body, is used to see how much the plaque is prominent, is there calcium build up present or not and how is the blood flow inside the penis.

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Treatments:

1. Oral Treatment:

Drug therapy is the most commonly used method to treat this disease in its acute phase.

However, there aren’t enough studies conducted yet to prove the efficiency of these medicines.

  • Oral Vitamin E: Vitamin E is an antioxidant which may reduce the size of plaques and straighten the penis gradually. It is known for its mild side effects and cost- effectiveness. 
  • Potassium Amino-Benzoate (“Potaba”): his vitamin B complex helps to eliminate plaque size but not the curve. This treatment is not cost-effective and the patient needs to take 24 tablets a day for 3 to 6 months. Most men stop this treatment as it can upset one’s stomach.
  • Tamoxifen: these non steroidal and anti estrogen drugs are used to treat desmoid tumor which is similar to plaques in structure.
  • Colchicine: is an anti- swelling drug which has been useful in few cases.Many patients stop consuming this medicine due to stomach issues.
  • Carnitine: is an antioxidant which reduces swelling and helps to heal wounds.

2. Penile Injection:

  • Verapamil Injection: used to treat high blood pressure, can also cure penile pain and curving. It is an economic and good option to treat Peyronie’s Disease.
  • Interferon Injection: is a protein complex manufactured in our body which helps in swelling and slows down the buildup of scar tissues and also accelerates breaking down of scar tissue.
  • Collagenase Injection:  helps in breaking plaque tissues.

3. Surgery For Peyronie’s Disease:

Surgery can be conducted on men whose plaque and curving has become very worse. There are three ways in which surgery is used to fix Peyronie’s Disease:

  • Making the side of the penis opposite the plaque shorter- 

         this surgery is most suited for less or no erectile dysfunction. This surgery is safe, easy to conduct and has low risk involved. The major drawback of this surgery is it shortens the size of the penis.

  • Making the side of the penis that curves longer- used when curving is severe or when shaft has become very narrow. This surgery does not shorten the size of the penis but there is always a risk of erectile dysfunction getting worse.
  • Putting a prosthetic device inside the penis- in men with Peyronie’s Disease and moderate erectile dysfunction, an inflatable pump or moldable silicone rod is placed inside the penis. This helps to straighten the penis and make it stiff enough for sex.

After Treatment:

The dressing is left on penis for almost 24 to 48 hours to prevent it from bleeding after surgery and protect the repair. Medicines can be prescribed to lower the risk of infection and reduce swelling and control pain as well. As recommended by doctors, one should not get involved in any sort of sexual intercourse for at least 6 weeks after surgery.








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