Peyronie’s disease is an acquired penile curvature due to scar tissue in the penile shaft.
This can cause penile pain and discomfort, can reduce or diminish the quality of erections, may complicate sexual intercourse, and can cause significant psychological burden for affected men and their sexual partners.
Peyronie’s is different from congenital penile curvature, as the latter is present since the time of birth, where Peyronie’s is acquired later in life. Some men will have penile pain associated with the onset of symptoms.
Curvatures can range in severity from a slight bend to significant curves greater than 90 degrees. Peyronie’s disease can make sexual intercourse painful, difficult, or impossible. In extreme cases, scar tissue may cause shrinkage or shortening of the penis.
The main symptom of Peyronie’s disease is the formation of flat scar tissue underneath the skin of the penis.
The scars, called plaques, can feel like lumps to the touch.
The scarring limits blood flow and leads to a constellation of potential symptoms including penile curvature, penile shortening, pain, and erectile dysfunction.
Peyronie’s disease can be very distressing to both the man and their partner. In fact, among men with Peyronie’s completing depression questionnaires, nearly 50% meet the threshold for clinically meaningful depression, and just over 50% reported relationship stress because of their Peyronie’s disease.
Peyronie’s disease can be found in up to 9% of men, most often occurring among men in their 50’s to 60’s but may occur in men of all ages.
Peyronie’s treatment options include penile injections, shockwave therapy (for pain reduction) and more.
Peyronie’s disease is variable among men. Based upon studies in the literature, we know complete resolution of penile pain occurs eventually for the great majority of patients without treatment.
With respect to penile curvature, only 12% of men will report improvement over 1 year if left untreated, while 21-40% will report no change in symptoms and 48-76% will report worsening curvature.
Treatment may reduce penile curvature and pain, and improve men’s sexual function.
The underlying cause for Peyronie’s is not known and is under investigation in doctor’s labs around the world. The proximate cause of the penile curvature is the Peryronie’s plaque scar tissue.
Normally, when the penis changes from a soft/ flaccid state, to an erect state, a series of neurochemical reactions occur that result in more blood entering the penis than leaves. For this to occur, the smooth muscle in the penis must relax and expand, as does the tunica albuginea (lining of these erectile chambers).
However, the lining that has a Peyronie’s plaque cannot stretch and expand like the remaining normal penis; thus, as the erection expands in length, the non-expanding plaque causes that section to be shorter than the opposite side resulting in a curve. Similarly, as the penis expands in girth with an erection, the plaque fails to expand and stretch and may result in an indentation, narrowing or tapering.
Research has suggested these agents as possible causes of plaque or scar formation in the penile shaft:
In most cases, based upon history and physical examination the doctor will be able to make the diagnosis. When the penis is flaccid, one may be able to palpate the ‘plaque’ or site of fibrosis on the penis; however, curvature to one’s penis and deformities can only accurately be assessed when the penis is erect.
In most cases our doctor will perform a penile curvature assessment where we will induce an erection with medication and perform a very detailed assessment of the abnormalities.
Peyronie’s disease treatments can include shockwave therapy for pain reduction, penile injections and surgical procedures.
The aim of most treatments is to stop the disease progressing further, maintain or improve sexual function, relieve any penile pain and to straighten the bend as much as possible.
The doctor will evaluate your case and determine a course of action.
RevibeMD is a procedural clinic offering emerging therapies for Peyronie’s disease and ED. Treatment at Revibe is not covered by provincial insurance plans. Our therapies should be considered in addition to other options not offered by RevibeMD.
Interferon
Interferon injections appear to disrupt the production of fibrous tissue and help break it down. It also has been shown to reduce penile pain in men with Peyronie’s disease.
Verapamil gel, a topical version of the drug, has also been effective in eliminating pain upon erection, decreasing the size of plaque, decreasing curvature, and improving erection quality in patients with Peyronie’s disease.
It is a prescription compounded medication that is applied directly to the skin. Verapamil belongs to the class of medications known as calcium channel blockers. The gel has been designed to carry the verapamil through the skin and deliver it to the Peyronie’s plaque. The proprietary formula allows for minimal absorption into the blood, while maximizing the concentration of verapamil in the plaque and surrounding tissue.
For men that are not candidates for other forms of therapy and are both psychologically and functionally bothered by their Peyronie’s Disease, surgery may be an option. This may include different techniques depending upon the nature of the curve, deformity, and baseline erectile function. The doctor will discuss these if they are appropriate but generally include:
Patients should do everything they can to improve their vascular and aerobic health. Exercise is very important as is a good diet. Lifestyle changes may allow a man to achieve an erection more easily, allowing him to continue having sex, even when he has Peyronie’s disease. Some of the potential lifestyle changes a man can try include:
A man may also want to undergo counselling to help with stress, anxiety, or depression. Understand that these lifestyle changes may not affect Peyronie’s disease. Changes of this kind are intended to improve the ability to have sexual intercourse without worrying about ED symptoms.
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Regina, SK S4V 3A3
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Saskatoon, SK S7T 0J1
Telephone:
306-373-8423
