Peyronie's Disease Guide
What is Peyronie's Disease?
The Peyronie's is a disease that affects men since it is a condition of the penis. When suffering from this disease, you will notice or feel some plaques under the skin of your penis. Plaques are parts filled with scar tissues. These plaques are responsible for a number of challenges faced by men suffering from Peyronie's disease, including indentation of the penis during erection and experiencing pain during erection.
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Peyronie's (pa-ro-NEEZ) disease is the development of fibrous scar tissue inside the penis that causes curved, painful erections. A slightly upward curved penis can stimulate vaginas on the G-spot, but anything more than a slight curve and different direction is generally undesirable.
If you have been referred to this page and are looking for a device that are specifically made to cure Peyronie's, this would be it.
The Working of a Healthy Penis
The penis has three major tubes, each being responsible for its unique purpose from passing urine, semen, and erection, respectively. The urethra is the tube responsible for disposing urine from the bladder while the other two tubes are known as the corpora cavernosa. These tubes are responsible for causing the erection in the penis once they are filled with blood.
The tubes in the penis are surrounded by a fibrous sheath known as the tunica albuginea. The Tunica albuginea is very tough and helps in stiffening the penis during sex once the Corpora cavernosa tubes are filled with blood. The ureter is then responsible for carrying the semen into the female vagina.
How common is the disease?
The Peyronies disease is more common among older men as compared to the younger generations. Men between 40 and 70 years are more likely to suffer from the disease, although cases have been reported on men in their 30s. In every 100 men within the mention age group, 6 of them are suffering from Peyronie's.
The number of men affected may be slightly, or even way higher than the estimated number since most of the cases go unreported. But surprisingly, in recent years, the number of reported cases has increased due to the launch of new erectile dysfunction meds into the market. Doctors have been noticing Peyronie's disease in patients seeking treatment for erectile dysfunction. It is, therefore, expected that the number of reported cases would increase.
When and How Does the Symptoms Show
As it has already been established, plaques are the key cause of Peyronie's disease. These plaques are majorly formed on the top side of the penis. The presence of the plaques causes the tunica albuginea to become less flexible, and this is what leads to the penis bending in either direction during erection. However, if the curve is more complex, the patient might be suffering from more than just a plaque condition.
The plaques may form on a particular part of the penis or all round it. If the latter happens, the penis may not curve, but a different effect of narrowing of the penis shaft will be observed. The shaft takes the shape of the bottle-neck hence the term waisting or "bottle-necking" for the condition. In other dire cases, the penis may become as hard as a bone due to the collection of calcium by the plaques. You may also realize that your penis is shrinking or becoming smaller.
Some of the other common symptoms of Peyronie's disease include:
- Bent penis
- Having soft erections
- Developing lumps in the penis
- Experiencing difficulties during sex as a result of the penis curving
- Feeling pain during erection
Many of the men suffering from this condition are afraid of speaking up, and this ends up affecting the quality of their life. Research has shown that 75 men out of every 100 men suffering from Peyronie's disease are depressed and stressed. You should seek medical attention the moment you notice any of the symptoms mentioned above.
Causes
The major cause of this disease is injuries caused to the penis. Penile trauma is common, especially due to rough sex, where the male partner ends up hurting his penis due to pressure for the female partner's pubic bones and bending of the penis during intercourse.
Other accidents, such as those that occur during sports, can also be another trigger. The tunica albuginea may be injured, causing the formation of scar tissues in the cells, often referred to as fibroids. The fibroids form the plaques responsible for the Peyronie's disease.
At this point, it is key to note that Peyronie's disease is a result of how the penis heals from the wounds or injuries caused to it.
Researchers have reported that not all cases of penile trauma result in Peyronie's disease. Some of these researchers believe that there are environmental and genetic reasons for the formation of Peyronie's plaques. Those men with Dupuytren's Contractures and other connective tissue disorders are at a greater risk of getting Peyronie's disease.
Other health problems such as pelvic trauma, tobacco smoking, and high blood pressure also expose men to the risk of contracting the Peyronie's disease.
Peyronie's stages
This disease has only two phases, and that is the acute and chronic phases. During both of the phases, you might experience erectile dysfunction as well as a bent penis.
The acute phase
the first stage, and it only lasts for 6 to 18 months, and during this period, plaques form, your penis bends, the curving intensifies, and you may experience pain when the penis hardens.The Chronic Phase
a more advanced stage, and during which time, the penis stops bending further, and the pain that came with erection disappears.Diagnosis of the Peyronie's Disease
When you notice one of the symptoms of Peyronie's disease, it is advisable that you seek immediate medical attention from a specialized professional. The health care staff can tell when one is suffering from the disease from just a simple physical examination of the penis since the plaques can be felt whether the penis is hard or not.
However, to observe the intensity of the curving, the doctor might inject the penis with a drug that makes it stiff for better observations. Ultrasound may also be applied to observe the exact location of the plaques and in determining whether there are any calcium deposits and the flow of blood in the penis.
Treating Peyronie's Disease
Most of the cases are not treated due to non-reporting by many of the men suffering from the disease. It is, however, important to mention that Peyronie's disease is curable, especially in its early stages (probably 12 months after the disease is dragonized.)
Early treatment saves you the risk of having to undergo surgery if the disease advanced into its chronic stages.
There is a myriad of ways in which you can choose to treat the disease, and some of them include:
Penile Injection
This is the most effective way of treatment as the drug is injected right into the problematic area in high doses as compared to oral drugs. The injection is best for those whose condition is in the acute stage. The skin is initially numbed before the injection to reduce the pain.
This is the safest form of treatment for those men that do not want to undergo surgery.
Interferon injection
The body makes a protein called interferon, and it is responsible for controlling swelling and scarring by reducing the rate at which scar tissues develop and by breaking down the scar tissues.
Verapamil injection
It has been used in the treatment of high blood pressure, and studies show that it can also work for Peyronie's. Although it appears to be more cost-effective, more studies on the application of this treatment for Peyronie's disease are needed.
Collagenase injection
The body makes its collagenase for breaking down certain body tissues. Injecting the plaques with collagenase fixes Peyronie's disease.
The use of Xiaflex, a collagenase injection drug, has been approved in the United States for the treatment of men with the penile curving of over 30 degrees.
Administration of oral drugs
Drug therapy has proved to be helpful in the treatment of mean suffering from the acute stages of Peyronie's disease. However, the available study reports are not enough to explain how these drugs work, and there is, therefore, a need for more research studied on the same.
Tamoxifen
This is an anti-estrogen and non-steroid drug majorly used for the treatment of desmoid tumors. These tumors are more like plaques, and the drug is presumed to work in the treatment of Peyronie's. Tamoxifen does not work any more effectively than a placebo since there is no study to show so. Placebo are drug-free sugar pills.
Vitamin E
This antioxidant is popular for its low cost and very mild side effects. Study shows that oral administration of vitamin E helps in straightening the penis and reducing plaques. Studies that used control groups reveal that vitamin E does not work as effectively as a placebo.
Colchicine
This is an anti-swelling agent and has proved to be helpful in some of the studies. These studies were carried out without control, and most of the patients using this drug complain of stomach issues before stopping using it. It is still to be proved to work better than a placebo.
Potassium Amino-Benzoate
The drug is also known as potaba and only helps in reducing the size of the plaques and not in any way the curving of the penis. Many patients do not prefer this Vitamin E complex as one has to take 24 pills every day for as long as six months. It is also costly, and patients have complained of stomach upsets.
Carnitine
It is an antioxidant that helps lower swelling for easy and complete healing of wounds. A recent controlled study showed that it did not work better than placebo.
Other Forms of Treatments
There are numerous ongoing studies on other alternative treatment of Peyronie's disease, but there is still not enough information to show that these alternatives work. One of these studies shows that if you stretch your penis for 2-8 hours a day for half a year, its length and curving will be restored.
Other studies are looking into the treatment of Peyronie's disease using shock-waves, ultrasound, verapamil, and radiation. These methods are, however, not proven and are yet to be used in the professional field practice.
Surgery
Surgery is the last resort for those with severe penile deformities that affect their sex life. However, according to health professionals, surgery cannot be conducted until a time when the plaques have completely formed, and the curving has reached completion. The patient must have been pain-free for a period of 9-12 months for surgery to be done.
The doctor may need to check the inside of the penis using ultrasound and to check blood flow into the penis by injecting it with a drug that hardens it before surgery. These tests are important in determining what type of surgery will be best for you.
The three main ways of fixing Peyronie's with surgery are:
- Fixing a Prosthetic Device in the penis
- Shortening the side of the penis that is directly opposite the plaques
- Lengthening the curved side of the penis
Fixing a Prosthetic Device in the Penis
Placing Moldable Silicone Rods or an Inflatable Pump in the penis helps in straightening it and making it hard enough during sex. This serves a good course in helping men with erectile dysfunction problems as well as those suffering from Peyronie's disease.
The surgeon can always straighten the device enough to meet the length of the penis by either cutting the plaque and filling the opening with graft or by modeling that plaque against the hard prosthetic.
Shortening the Side of The Penis That Is Directly Opposite the Plaques
One way of conducting this type of surgery is by cutting pieces of tissues on the outside of the penile curve then sewing it closed. The other way is by folding tissues and later pulling them tightly together with surgical threads.
Although this approach has the lowest risk and is easy to do, it has its setbacks, such as making the penis shorter. It is the best option for patients with mild or no erectile dysfunction, long penis, and mild or moderate penile curve.
Lengthening the Curved Side of the Penis
The surgeon will arrive at the decision of applying this procedure if the patient has a very shallow shaft or the penile curve is very severe. The procedure includes cutting and removing some of the plaques to help ease the tension and filling the spaces with grafts.
This procedure may not make your penis shorter, but there are higher risks that the ED might get worse. It is only recommended for patients with very severe penile deformities, and only those that can get their penis hard enough during sex.
Types of Penile Grafts
Grafting is the procedure of moving body tissues from one part of the body to a different part. It can also be done by replacing the tissues in a body with those from a donor or with a laboratory-made tissue replacement.
For penile grafting, it is done to fill in the spaces left after removal of some or all of the plaques from the penis. Your surgeon will guide you in choosing what type of grafting that will be best for your condition.
There are two common types of grafting for penile deformities:
1. Autologous Tissue Grafts
Here, the spaces are filled with tissues taken from another part of the patient's body. Some of the sources for grafts during a Peyronie's surgery include the Saphenous Vein from the leg or the Temporalis fascia (the skin behind the ear).
The good thing about autologous grafts is that they are made of living tissues are therefore continue to grow in the surgical site. The only setback of using autologous grafts is that the surgeon has to have a different surgery procedure to harvest the grafting tissues.
2. Non-Autologous Allografts
These are commercial tissues made from either animal or human sources. They have to be sterilized and checked for tissues likely to cause infection before use.
These grafts only act as support for your body to grow its own tissues as the grafts get absorbed by the body. They are often tolerable for most patients and are easy to use.
Man-made grafts such as GORE-TEX and Dacron Mesh are no longer being used for Peyronie's surgery procedure as they are likely to cause fibroids, which subsequently worsen the deformity.
Frequently Asked Questions (FAQs)
Below are some of the frequently asked questions concerning the Peyronie's disease:
Is Peyronie's disease cancerous?
For a fact, the cells from a Peyronie's plaque have similar characteristics as cancer cells, such as causing tumors when placed in a mouse without an immune system and not dying normally. However, there is no reported case of a Peyronie's plaque turning into cancer for humans.
If at all, you are observing symptoms that are beyond those of Peyronie's disease such as penile pain, trouble peeing, or external bleeding, then a further study of the biopsy should be conducted.
Are patients suffering from Peyronie's disease prone to different illnesses?
Statistics have it that 13 out of every 100 men with Peyronie's end up getting fibroids in different parts of the body, with the most common being the feet and the hands.
One of the conditions that have been linked to Peyronie's disease is Dupuytren's Contracture, where fibroids grow on the palm tissues. This disease leads to permanent bending or curving of the fingers. However, it is still not known what causes the link between Peyronie's disease and Dupuytren's Contracture.
What is the cause of Peyronie's disease?
It is consistently thought that Peyronie's disease normally develops after an injury or trauma which causes bleeding inside of the penis. But, while this kind of trauma might explain severe cases of Peyronie's disease, it doesn't explain the reason most cases will develop progressively and slowly (chronic cases), or what is the cause of the disease when there is no apparent accident or traumatic event. There may be a genetic component to Peyronie's disease.
What exactly happens with Peyronie's disease?
Peyronie's disease is a hard lump, or plaque, which forms on the erection tissue of the penis.
Fortunately, such plaque is non-cancerous (or benign) and will often begin as an inflammation which may develop further into a fibrous tissue.
In most cases, when the penis heals after a year or so, this plaque doesn't progress much beyond the initial inflammatory stage.
But, if the disease lasts for several years, the plaque frequently becomes a fibrous, tough tissue, and calcium deposits might form.
What are some symptoms and signs of Peyronie's disease?
While individuals might experience varying symptoms, the more common symptoms of Peyronie's disease will be:
Plaque: Which causes the penis to curve upward, if present near the top of the penis). Also, this plaque causes the penis to curve downward, if present near the underside of the shaft) .
Penis shortening: In instances where plaque develops on bottom and top, shortening and indentation of the penis might occur. bending, pain, and some emotional distress may prohibit sexual intercourse. Painful erections might happen.
Also, it should be noted that symptoms of Peyronie's disease might resemble other medical problems or conditions. Therefore, it is always recommended that you consult a doctor for a diagnosis.
What is the most commontreatments for Peyronie's disease?
The objective of treatment is to allow the patient suffering from Peyronie's disease to remain sexually active. Providing information on the disease and it's course is usually included with the treatment plan. In select cases, treatment may not be needed, as Peyronie's disease can often occur in a very mild form which heals without any treatment in six to fifteen months.
Treatments can include:
Surgery: Surgery is usually the last resort and can be associated with high-risk of complications, side effects and costs.
Vitamin E: Various clinical studies have reported some improvements with oral vitamin E as prescribed by a doctor.
Drugs: In select cases, shots of various chemical compounds into the plaques have been used in a limited number of patients. But this method of treatment can have a strong chance of un-wanted side effects.
Radiation therapy: using this treatment method, radiation is shot at the plaque to help reduce pain, but doesn't affect the plaque directly; worsening of the disease or un-wanted side effects may occur.
Using extenders: Such as the PhalloGauge penis extender to completely correct a slight case of curved penis. Penis extenders were originally developed to help treat/cure Peyronie's disease. Not only are they effective in doing so, an unintended side effect was an increase in growth.
This extender is specifically made to treat Peyronie's.
Common Misconceptions
As with a lot of diseases and health disorders, there are several misconceptions and untrue assumptions and myths surrounding Peyronie’s disease (PD). Lets distinguish between fact and fiction.
Myth #1 - PD is a young persons' disease.
The Fact Is - Over 75% of all patients who suffer from PD are between the ages of 45 & 65. Also, there are people who believe Peyronie’s disease only afflicts males over the age of 50. The truth is- almost 10 percent of patients can present at or below age 40.
Myth #2 - PD is a ailment without known cause.
The Fact Is - It is true there is no single cause is responsible in each and every case of PD. Generally, it’s assumed that some sort of injury / trauma to the penis causes PD. Also, Peyronie’s disease is associated with diabetes and hypertension. Similarly, it is also linked with Ledderhoseis disease (plantar aponeurosis), knuckle pads, Dupuytrenís disease (palmar aponeurosis) and Pagetis disease. The disease seems to run in families as well, from generation to generation.
Myth #3 - PD will lead to cancer.
The Fact Is - Plaque developed in PD is benign, non-cancerous (non-malignant). It's not a tumor and it can't spread to adjacent body parts of tissue. Also, Peyronie’s disease isn't contagious (it can't be transmitted from person to person by any means) and it isn't known to be the result of any transmittable disease.
Myth #4 - The best option to completely cure every case of PD is surgery.
The Fact Is - Surgery is among the most risky, complex and expensive treatment option and is almost always stated as the final resort whenever other treatments don't work. Additionally, even the most successful surgeries can't guarantee the disease will not come back in the future. Similarly, not every surgery has shown 100 percent resolution of all signs and symptoms of PD.
Myth #5 - There isn't a link connecting erectile dysfunction and Peyronie’s disease.
The Fact Is - Even though both conditions may occur independently, PD is connected with erectile dysfunction (male impotency) in most cases. Recent research shows the link between erectile dysfunction and Peyronie’s disease is much clearer than was previously thought. Trials and Published studies have shown that as many as 30 to 80 percent of males may suffer from erectile dysfunction connected to Peyronie’s disease.