Peyronie's Disease: What It Is, How It's Caused, and What Can Be Done About It
Nothing strikes fear in the hearts of men like diseases that directly affect the penis, and Peyronie's disease is no exception. While this condition only affects about 5 percent of all men, those who suffer from it know that it can be devastating to a good sex life and can cause serious anxiety issues that interfere with the overall quality of life.
Peyronie's disease is caused by scar tissue inside the penis, which results in erections that are markedly curved and often very painful. While it's not very well understood yet, Peyronie's is thought to be caused by a serious injury, or repeated minor injuries, to the penis. In most cases of Peyronie's, however, the patient doesn't actually recall suffering an injury.
Each side of the penis features a tube called a "corpus cavernosum," which contains a large number of tiny blood vessels. Arousal causes the vessels to fill with blood, and the penis becomes erect. The corpus cavernosum is encased in a sheath called the "tunica albuginea," which is highly elastic and stretches during an erection. When scar tissue builds up on this sheath, it doesn't stretch as the penis becomes erect. As a result, the penis bends during an erection.
For a small number of men who suffer from this condition, the curvature goes away on its own after a year or two. Unfortunately, in most cases, the curvature stays the same or worsens over time, requiring medical intervention.
The symptoms of Peyronie's disease may exhibit gradually over time, or they may come on suddenly. The first symptom is usually the buildup of scar tissue that can be felt under the skin of the penis. The scar tissue may feel like a series of lumps or hard bands. The appearance of the penis may undergo changes as well, such as narrowing in places, visible indentations along the shaft, or developing an hourglass shape with a marked narrowing around the shaft.
As a result of the scar tissue, the erect penis is significantly bent up, down, or to one side, depending on where the scar tissue is located. The bending of the penis often results in a great deal of pain when it's erect, and sometimes even when it's flaccid. The bend may make sexual intercourse difficult or impossible, and it can make maintaining an erection difficult.
In most cases of Peyronie's disease, the pain decreases over the course of a year or two, although the curvature typically remains due to the buildup of the scar tissue.
While injury to the penis is the most common cause of Peyronie's, there are a few risk factors that may contribute to the buildup of scar tissue, according to recent research.
Heredity may play a role in the development of Peyronie's. If your father or brother suffers from this condition, you may be at higher risk for developing it, too. Additionally, a connective tissue disorder called Dupuytren's contracture, which is a thickening along the palm of the hand that causes the fingers to curve inward, is commonly found in those who suffer from Peyronie's. Smoking is a common factor among those who suffer from the disease, and researchers have also found a link between Peyronie's and certain types of prostate surgery. Age may also be a factor, due to changes in aging tissues that leave them more vulnerable to injury and slow down their ability to heal.
Pain, discomfort, and the inability to have sex are often physical realities for those who suffer from Peyronie's disease. While the physical symptoms of this disease can be devastating, the psychological problems that often result are as just acute and problematic for most men.
Anxiety about the inability to have sex, as well as about the appearance of the penis, can cause serious damage to your overall physical health and sense of wellbeing. Relationship stress is also common for those who suffer from Peyronie's, and this can cause long-term problems in the relationship that may outlast the disease.
The good news is that there are a number of treatment options for Peyronie's disease.
The diagnosis of Peyronie's is typically made through a physical exam of the penis. In some cases, an ultrasound may be used to identify the presence and location of scar tissue and measure blood flow to the penis.
If the curvature of the penis isn't severe and it's not getting worse, and you can still have sex without pain, treatment will likely be of the wait-and-see variety. This is called "watchful waiting," and it may include taking measurements of the hard and flaccid penis and keeping photographs of the erect penis on file for comparisons later on.
In more severe cases of Peyronie's, an injection into the penis at the doctors office may be prescribed to help reduce the formation of plaque and ease the pain, as well as reduce the curvature of the penis. This drug was approved by the FDA in 2013 and can effectively treat Peyronie's in men who have distinct lumps from the buildup of scar tissue and who have a penis curvature of 30 degrees or more when erect. This drug is injected directly into the penis at the doctor's office and helps break down the collagen that has built up. The injection is followed by simple exercises that stretch the penis to help straighten it.
Surgery is another treatment option. Although it's not recommended until after the curvature of the penis stops increasing, it may be a viable option for those with severe penile deformity or pain associated with Peyronie's.
During surgery, the unaffected side of the penis may be stitched to help straighten it, although this can result in the shortening of the penis or in erectile dysfunction. Another surgical option is to remove scar tissue and replace it with a graft. In very severe cases, implants may be used to replace the corpus cavernosum, which fills with blood during an erection. The implant may be manually bent up for the purpose of having sex, then bent back down afterwards. Alternatively, the implant may be inflated with a pump that's implanted in the scrotum.
Ongoing research into the causes, risk factors, and treatments of Peyronie's disease will eventually lead to better ways to prevent and treat this condition. In the meantime, protect your penis during athletic activity, and avoid extremely vigorous sex that can cause injury. If you experience symptoms of Peyronie's, visit your doctor right away to explore options for treatment and pain management before the disease progresses.