Who gets Peyronie’s disease?

Peyronie’s disease occurs in about 10% of all middle-aged men, however, younger and older men can also be affected by the disease. In some cases, men who have a family history of Peyronie’s develop the disease, which indicates may be hereditary.

A man who has Peyronie’s disease may also suffer from Erectile Dysfunction (ED).  Symptoms of Peyronie’s can lead to less blood flow to the penis and ED may cause the penis to bend more during sexual intercourse.

What causes Peyronie’s disease?

The cause of Peyronie’s disease is not fully understood. Many researchers believe the plaques occur after the penis has been hit or bent, causing trauma and bleeding inside the penis.

Many medications can also cause Peyronie’s disease as a side effect, including:

• Beta blockers, which are often prescribed for people with heart conditions or high blood pressure
• Interferon, which is used to treat multiple sclerosis
• Dilantin, an anti-seizure medicine

What are the symptoms of Peyronie’s disease?

The main symptoms of Peyronie’s cannot be seen while the penis is soft. Symptoms can develop slowly or appear overnight. In severe cases, the plaque makes the penis less flexible and can cause pain and force the penis to bend or curve during an erection.

Pain from Peyronie’s disease is usually mild and is typically not treated. In most cases, the pain decreases over time, but the bend in the penis remains a problem. Occasionally, milder forms of the disease will get better without causing pain or permanent bending. Peyronie’s disease may also make the erect penis shorter and this change may be permanent.

Approximately 1 in 3 men with Peyronie’s disease experience some pain during intercourse.

Diagnosis and Tests:

How is Peyronie’s disease diagnosed?

The doctor will ask the patient about any incidents that may have happened prior to experiencing the symptoms such as an injury. The doctor will feel the hardened tissue and sometimes it is necessary to examine the penis when it is erect.

In some cases, the doctor may perform a biopsy to send for testing to assist in diagnosis.

Management and Treatment:

How is Peyronie’s disease treated?

Mild bending of the penis caused by Peyronie’s disease usually does not need to be treated. Since the disease can improve on its own in some cases, doctors often recommend waiting before having surgery.

Surgery may be helpful only in cases where there is a severe bending of the penis that keeps a man from having sexual intercourse. In these cases, there are two procedures to correct the problem: plication and plaque removal.

Plication:
In a plication procedure, the doctor shortens the “long side” of the erect penis by operating on the opposite side from where the scar or plaque is located. The procedure straightens the penis and allows the man to keep an erection, but it does cause the erection to be a little shorter.

This is an outpatient (same-day) procedure and the doctor does not remove any skin. Plication is successful more than 90% of the time.

Plaque/scar tissue removal:
In this procedure, the doctor removes plaque or scar tissue to allow the short side of the penis to expand and become straight. This procedure is usually done in men who have very severe bending of the erection.

After removing the plaque, the surgeon fills in the gap in the erectile chambers with a graft, which is collected from somewhere else on the patient’s body, or obtained from a commercial source.

This procedure is successful in 75% of cases and helps preserve the length of the erection, but the erection will not be as long as it was prior to the disease.

With Plaque tissue removal there is a greater risk of side effects, including:

• Weak erection or erectile dysfunction that may additional medical intervention
• A temporary change in sensation in the penis
• A longer recovery period after the operation

Since Peyronie’s disease affects each man differently, you should talk to your doctor about the right treatment for you.

Prevention:

How can men prevent Peyronie’s disease?

Men may not realize that they can damage their penis during sexual intercourse; making it difficult or even impossible to have sex. To avoid this type of injury there are a number of things a man and his partner can do.

As men age, their erections may be less rigid or there may be difficulty in maintaining firmness. Less rigid erections can be injured because regular thrusting during sexual intercourse bends the penis. The following suggestions can help:

1. Doctors will usually prescribe oral medications (Viagra, Levitra, Cialis) when a man has erectile dysfunction and sexual intercourse is either difficult or impossible. The first step in avoiding penile injuries is to begin to use one of these medications as erections become less rigid.
2. The woman should make sure that the vagina is lubricated. If it is not, the woman should use an over-the-counter vaginal lubricant.
3. If the penis slips out of the vagina during sexual intercourse, the man or his partner should use their hand to guide it back in.
4. Sexual intercourse with the partner on top should be avoided or used with caution because this position may increase the chances of the penis bending.
5. Regardless of the position, the man’s thrusting movements during sexual intercourse should be straight in and out. He should avoid movements that might bend or twist the penis.
6. Sexual intercourse should be avoided when the man is tired or has had too much alcohol to drink as erections may be less reliable on these occasions.