Peyronie’s Disease is the presence of excess collagen formations (often called plaque) that affects the erectile bodies of the penis. The fibrotic lesions reduce penile tissue elasticity and can result in penile curvature, painful erections, constrictions (hour-glass deformity), loss of length or girth and erectile dysfunction. The prevalence of PD is reported as high as10% of the male population with a slightly increasing incidence with older age.
A man’s initial response to palpating a hard nodule on the penis can cause a lot of anxiety and concern about a possible malignancy. Patients can easily be reassured by their physicians that Peyronie’s plaques are benign lesions and are only associated with sexual dysfunction.
Trauma to the penis is one of the most common causes of PD and can result during regular sexual intercourse when the penis bends or is struck severely, leading to scar tissue formation or plaques. These plaques can decrease normal tissue elasticity with the resultant changes in penile appearance. Genetics can predispose patients to PD. The presence of a family member with PD or other fibrotic tissue disorders such as Dupuytrens contracture or plantar fibromatosis is associated with this condition. Medications belonging to certain drug classes have been reported to cause PD. Beta-blockers, anti-seizure medication (phenytoin) and certain supplements such as glucosamine / chondroitin or large doses of vitamin C are associated with PD.
Treatment options for patients with PD are various and depend on the degree of curvature and sexual disability in the individual patient. Many proven and unproven treatments exist. Your physician will determine which treatment option is appropriate for you. Treatment options found to be beneficial include:
- Oral Medications
- Vitamin E
- Colchicine
- Pentoxyfilline
- Topical Medications
- Verapamil Cream
- Plaque injections
- Verapamil
- Collagenases
- Interferon
- Mechanical Traction Devices
- Surgery
Penile Plication
The penis is straightened by placing some plication sutures in the tunic of the corpora cavernosa
Penile Grafting
The penis is straightened by excising the plaque and placing a graft material over the defect
Penile Prosthesis and Modeling
The penis is straightened by placing a penile prosthesis and modeling the penis over the prosthesis. This is the treatment of choice for men with Peyronie’s Disease and concomitant erectile dysfunction (E.D.)
Penile Prosthesis and Penile Plication/Grafting
In cases of severe Peyronie’s Disease associated with erectile dysfunction, a combination of penile implantation and penile plication/grafting is required to achieve a good functional and cosmetic result.