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Peyronie's disease

Peyronie's disease

What is Peyronie's disease?

A condition in which the penis becomes curved during an erection.

What are the main symptoms?

  • Hard lumps, known as plaques, form in the fibrous erectile tissue of the penis.
  • A plaque usually forms on the top of the shaft, causing the penis to bend upward.
  • A plaque on the underside causes it to bend downward.
  • If the plaque develops on both the top and the underside of the penis this can lead to indentation and shortening of the penis.
  • The thickened area may be painful when the penis is erect.
  • It can be difficult to get an erection (the plaques may obstruct blood flow in the penis).
  • The pain and the bending of the penis may physically prevent sexual intercourse.

What's the risk?

Peyronie's Disease is thought to affect 1 to 9% of men. Men aged 50-60 are most at risk, although the disease occurs in younger and older men or in men with diabetes.

N.B. The lumps in Peyronie's disease are benign and not linked to cancer of the penis. Nor is it caused by sexually transmitted infections, such as gonorrhoea.

Peyronie's disease

  • Causes
  • Diagnosis
  • Treatments

    It is the result of damage to the penis, due to internal bleeding, due to stretching of penile blood vessels. There is some evidence that the elasticity of the penile tissues is reduced in older men and that minor damage may occur (without any obvious outward signs) during sexual intercourse. Some cases may be caused simply by turning over in bed while asleep with a nocturnal erection.

    In mild cases the plaque does not advance beyond an initial inflammatory stage, but in severe cases tough fibrous tissue develops and calcium deposits may even build up.

    How can I prevent it?

    You can't, except perhaps by avoiding sexual acts, which might damage or over-stretch the penis.

    Should I see a doctor?

    If you notice lumps in your penis, you should go straight to your doctor.

    You will need to have a physical examination and an ultrasound.

Surgery is the only treatment known to be effective. However, if intercourse is possible without pain, Peyronie's disease may be managed without surgery. Drugs have been used to reduce the plaque in the initial stages along with injections to the plaque. Recently shock wave therapy has been used.

Surgery

The surgery is dependent on the patient plaque length and the area affected.

  • Removal of the plaque and grafting with a patch of tissue. This can lead to erection problems, particularly loss of rigidity.
  • Removal of tissue from the side of the penis opposite the plaque to cancel out the bend (Nesbit procedure). However this may lead to shortening.
  • A device (prosthesis) can be implanted in the penis to increase its rigidity. This may be combined with incisions and skin grafts if the penis is still not straight.

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