Peyronie's (pa-ro-NEEZ) disease is the development of fibrous scar tissue inside the penis that causes curved, painful erections.
Men's penises vary in shape and size, and having a curved erection is common and isn't necessarily a cause for concern. However, in some men, Peyronie's disease causes a significant bend or pain. This can prevent a man from having sex or may make it difficult to get or maintain an erection (erectile dysfunction). For many men, Peyronie's disease also causes stress and anxiety.
In some cases, medications may help. Surgery to treat Peyronie's disease is generally only recommended if the curvature and pain are severe enough to prevent sexual intercourse.
Peyronie's disease symptoms may appear suddenly or may develop gradually. The most common signs and symptoms include:
The curvature associated with Peyronie's disease may gradually worsen. At some point, it generally stops getting worse. In most men, pain during erections improves within one to two years but the scar tissue and curvature remain. Rarely, both the curvature and pain associated with Peyronie's disease improve without treatment.
When to see a doctor
The cause of Peyronie's disease isn't completely understood, but a number of factors appear to be involved. It's thought Peyronie's disease generally results from the rupturing of small blood vessels inside the penis. For example, the penis may be damaged during sex, athletic activity or as the result of an accident. During the healing process, blood cells and other cells are trapped at the site of injury, which leads to the buildup of scar tissue. However, not all men who have a penis injury develop Peyronie's disease. It's thought that inherited traits may play a role in who is susceptible to the disorder.
Each side of the penis contains a sponge-like tube (corpus cavernosum) that contains many tiny blood vessels. When you become sexually aroused, blood flow to these chambers increases. As chambers fill with blood, the penis expands, straightens and stiffens into an erection. Each of the corpus cavernosa are encased in a sheath of elastic tissue called the tunica albuginea (TOO-nih-kuh al-bu-JIN-e-uh), which stretches during an erection. Injury to the penis can damage this tissue. If an injury heals properly, there are generally no long-term problems. In Peyronie's disease, problems in the normal wound-healing process result in permanent scar tissue. The section of the sheath with scar tissue is no longer flexible. When the penis becomes erect, the region with the scar tissue doesn't stretch, and the penis bends or becomes disfigured and may be painful.
In some men, Peyronie's disease comes on gradually and doesn't seem to be related to an injury. Researchers are investigating whether Peyronie's disease might be linked to immune system disorders.
The penis contains two cylindrical, sponge-like structures (corpus cavernosum). When a male becomes sexually aroused, nerve impulses increase blood flow to both cylinders. This sudden influx of blood ...
Minor injury to the penis doesn't always lead to Peyronie's disease. There are a number of factors that can contribute to poor wound healing and scar tissue buildup that may play a role in Peyronie's disease. These include:
Other factors, including other certain health conditions, smoking and some types of prostate surgery may be linked to Peyronie's disease.
Complications of Peyronie's disease may include:
Preparing for your appointment
If you have Peyronie's disease symptoms, you're likely to begin by seeing your family doctor or general practitioner. You may be referred to a specialist in male sexual disorders (urologist). Preparing for your appointment will help you make the best use of your time.
What you can do
List questions for your doctor from most important to least important in case time runs out. You may want to ask some of the following questions:
In addition to the questions you've prepared to ask your doctor, don't hesitate to ask questions during your appointment if you don't understand something.
What to expect from your doctor
Your doctor may also ask you to complete a survey, such as the International Index of Erectile Function, that may identify how the disorder affects your ability to have sex.
Tests and diagnosis
For most men, Peyronie's disease can be diagnosed with a physical exam and by answering questions about symptoms. Rarely, other conditions cause similar symptoms and need to be ruled out.
Tests to diagnose Peyronie's disease and understand exactly what's causing your symptoms may include the following:
Treatments and drugs
Your doctor may recommend a wait-and-see (watchful waiting) approach if:
If your symptoms are severe or are worsening over time, your doctor may recommend medications or surgery.
In some cases, drugs injected directly into the penis may reduce curvature and pain associated with Peyronie's disease. If you have one of these treatments, you'll likely receive multiple injections over several months. You'll be given a local anesthetic to prevent pain during the injections.
Evidence on the effectiveness of penile injections is limited. Medications that are used include:
Collagenase, an enzyme that breaks down fibrous tissue scar, is currently being studied for treatment of Peyronie's disease.
Common surgical methods include:
The type of surgery used will depend on your condition. Your doctor will consider the location of scar tissue, the severity of your symptoms and other factors. If you are uncircumcised, your doctor may perform a circumcision during surgery.
Depending on the type of surgery you have, you may be able to go home from the hospital the same day or you may need to stay overnight. Your surgeon will advise you on how long you should wait before going back to work — in most cases, a few days. After surgery for Peyronie's disease, you'll need to wait four to eight weeks before you masturbate or have sex.
Nesbit plication is one type of procedure to shorten the side of the penis that doesn't have scar tissue. An injection of a saltwater solution delivers a drug to create an erection. (1) The outer ...
Coping and support
Peyronie's disease can be a source of significant anxiety and create stress between you and your sexual partner. The following suggestions may help you cope with Peyronie's disease:
Last Updated: 2011-08-18
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