Peyronie’s disease is caused by scar tissue, also known as plaque, that forms on the penis, causing it to bend or curve, developing a lump. It can lead to painful erections, the loss of penile length and girth, and sometimes even erectile dysfunction. It is a common disease, more likely to appear in older ages. Peyronie’s occurs in about 6-10% of middle-aged men.
Peyronie’s can be induced by trauma or injury, that might cause bleeding inside the penis, but it is also believed that in some cases it develops on a genetics basis.
Stages
Peyronie’s, also known as Induratio Penis Plastica has two distinct stages:
– Acute phase: stage lasting from 6 to 12 months, during which the scar forms under the skin of the penis, leading to curvature and painful erections
– Chronic phase: during this stage the plaque stops growing, so there is no more curvature, and pain during erections might be gone, but Erectile Dysfunction may develop.
After this period, when plaque formation has stopped, the patient should seek immediate treatment.
EXAMINATION
Diagnosis is made by a urologist that will examine erectile function and the tissue formation. They will also ask about what happened before the symptoms started appearing, in order to find the source of the injury, although in many cases, men can’t pinpoint the event.
In some cases, healthcare providers will request an ultrasound in order to determine where the plaque inside the penis is, and how much it has advanced. This will also facilitate to determine treatment options.
NON- SURGICAL TREATMENT
Although you should seek examination immediately after noticing the symptoms, some men might not need treatment, as in some rare cases the pain might be mild or subside, and loss of penile length might not occur.
For this reason, many doctors recommend to wait for at least a year, so that the two stages of the condition (acute and chronic) occur first.
There are several ways to treat Peyronie’s. Which will be needed will be decided by your doctor, according to the cases severity:
Pills will be prescribeed, such as pentoxifylline, tadalafil and Potassium amino- benzoate, which will reduce plaque buildup and improve blood flow
a vacuum is used by the patient himself on a daily basis, which can improve curvature. Although, in some cases, more it can cause more stretch on the scar tissue.
non- surgical option. Injections of verapamil, Interferon or collagenase (Xiapex) can be made to reduce scar tissue, thus curvature and penile pain.
SURGERY
The most effective treatment, used mostly for severe cases. There are three options when it comes to surgical correction. All of them are performed take between 1 and 2 hours, and the patient can return home on the same day:
the plaque is removed surgically, and replaced with skin tissue taken from the patient
this surgery is performed by making the side of the penis opposite the curvature shorter, by cutting small pieces of tissue, and then sewing the remaining tissue closed.
an inflatable prosthetic is implanted in the penis, which will facilitate blood flow and allow the patient to achieve erections by controlling a pump that is part of the device.
There is a high success rate for all these surgeries, although there can be some risks, like device malfunction (for prosthesis, less than 15% chance, at more than 10 years after the surgery) , and implant infection (less than 2% chance). Some loss of length can occur with skin grafts or pilification.
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