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Peyronie's Disease

A Condition that Affects the Penis

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Updated October 15, 2008

Peyronie's disease is a condition that affects the penis. A plaque or hard lump of scar tissue forms on the penis in the layers of erectile tissue. The plaque may begin as inflammation (redness and swelling) and harden into a scar. It is not cancerous. Researchers aren't sure what causes the plaque to form. Some have suggested it comes from injuring the penis by hitting it or bending it, especially during intercourse, but this doesn't explain why most cases develop slowly or why many cases go away on their own.

The plaque forces the penis to bend during an erection, which may be painful. All men's penises bend a little when erect, but in Peyronie's disease the bend is very obvious, and it may be difficult or impossible to have intercourse because of it. In some cases, a plaque forms on both the top and the bottom of the penis, which can cause shortening or the erect penis to look like it has a tight band around it.

Who Gets It?

Studies have found that men of any age can develop Peyronie's disease. Since researchers aren't sure what causes it, it is hard to predict who might develop it. Also, different studies have found different rates of occurrence in men, anywhere from 0.38% to 3.2%.

Diagnosis

Diagnosis of Peyronie's disease is based on physical examination. The hard plaque can be examined whether or not an erection is present. An ultrasound scan of the penis can determine the location and extent of the plaque and evaluate blood flow throughout the penis.

Treatment Without Surgery

For many men with Peyronie's disease (5% to 40% of cases), the condition never goes beyond the inflammation stage, and this resolves without treatment within a year or so. For men who develop a hard plaque, other than surgery there are few established options. Some researchers have tried Vitamin E orally, but this therapy has not been shown conclusively to work.

Another treatment is the injection of chemical agents directly into the plaque. Verapamil or interferon are sometimes used. Creams, ultrasound, stretchers/extenders and other treatments are being studied but none have been proved effective.

Surgery

In more difficult cases, after waiting for 6 months to 1 year to see if the problem resolves, a surgeon can either remove the plaque or cut into it so it spreads open. Then tissue has to be grafted over where the plaque is/was. This can be with the man's own tissue (from his groin), a commercial biological product, or sterilized tissue donation from a cadaver.

Another option is to leave the plaque but remove or pinch the tissue on the opposite side of the penis to cancel out the bending. Men who have this done sometimes don't like it because it shortens the length of the penis. Both types of surgery may leave a man with problems having or maintaining erections.

A third surgical technique is the implanting of a device in the penis that can be inflated. If the bending is not too severe, the implant itself may straighten out the penis; if necessary, the plaque will also be removed.

More Research Needed

Finding out what causes Peyronie's disease would help physicians treat it. Studies have examined the condition as an autoimmune disorder (the body attacking its own cells) and as a problem with wound healing. Future research could continue these investigations and look at treatment alternatives to surgery.

Sources:

"Peyronie's Disease." Kidney & Urologic Diseases A-Z List of Topics and Titles . Sep 2005. National Kidney and Urologic Diseases Information Clearinghouse. 13 Oct 2008

Hellstrom, W.J.G. "Discoveries in Peyronie's disease: Etiology, prevalence, and therapies." American Urological Association 95th Annual Meeting (29 Apr 2000)

Hellstrom, W.J.G. "Surgical therapy for erectile dysfunction." American Urological Association 95th Annual Meeting (29 Apr 2000)

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