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Peyronies Disease

  • Male reproductive organs

Definition

Peyronie's disease is a disorder in which one or more small areas of plaque, or fibrous tissue, develop in the penis. This abnormality causes painful erections and difficulty with intercourse.

What is going on in the body?

Men with Peyronie's disease develop one or more areas of plaque on the penis. The man may experience a mild aching in a specific area of the penis well before any lump or plaque can be felt. The areas usually develop on the upper side of the penis but are sometimes found on the underside. The plaque may be painless, but the ability of the penis to become erect can be affected. The penis may be curved when erect, with resulting pain. As time goes on, the plaque may spread, causing more bending of the penis or discomfort.

Risks

What are the causes and risks of the disease?

Sometimes, Peyronie's disease is due to infection or trauma, but usually the cause is unknown. It is most common in men in their 40s to 60s, but can be seen as early as the 20s and 30s.

Prevention

What can be done to prevent the disease?

There is no known way to prevent Peyronie's disease.

Diagnosed

How is the disease diagnosed?

Diagnosis of Peyronie's disease begins with a medical history and physical exam. Generally, no tests are needed to make the diagnosis.

Long Term Effects

What are the long-term effects of the disease?

Peyronie's disease progresses slowly, if at all, and may resolve on its own.

Other Risks

What are the risks to others?

Peyronie's disease is not contagious and poses no risk to others.

Treatments

What are the treatments for the disease?

Because the cause of Peyronie's disease is still unknown, it is difficult to plan a treatment that works for everyone. There is no definite cure for Peyronie's disease. Peyronie's disease and all of its symptoms may wane or disappear in some individuals. Because of this, many experts recommend that a man wait 1 to 2 years before having surgery.
If the bend in the penis is so severe that intercourse is impossible, surgery may be recommended. Surgery may also be offered to men with erectile dysfunction. The scarring plaque that causes the bend may need to be removed or cut to straighten the penis. This usually affects the quality of erections. A penile implant may be inserted to improve erections.
Several medical treatments have been effective in small studies of men with Peyronie's disease. However, there are no large controlled studies to support these treatments. Further research is needed on these therapies, which include:
  • injections of collagenase, an enzyme that attacks the fibrous tissue, into the plaque
  • injections of medicines designed to control high blood pressure, such as verapamil, into the plaque
  • injections of steroids into the plaque
  • iontophoresis, a procedure that uses a painless current of electricity to insert a medicine or other substances under the skin covering the plaque
  • paraaminobenzoate (i.e., Potaba), a B vitamin derivative, taken orally
  • shock wave lithotripsy to the affected area
  • colchicine taken orally
  • vitamin E taken orally

Side Effects

What are the side effects of the treatments?

Paraaminobenzoate can cause loss of appetite, fever, or rash. Injections into the plaque may cause allergic reactions, infection, and further scarring. Surgery may cause bleeding, infection, and allergic reaction to anesthesia.

After Treatment

What happens after treatment for the disease?

If treatment is successful, the man will be able to have satisfying erections and sexual intercourse. Many times, however, the disease interferes with sexual function.

Monitor

How is the disease monitored?

Any new or worsening symptoms should be reported to the healthcare professional.

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