Peyronie’s disease is a condition where scar tissue develops in the penis, causing a curved or painful erection.
Peyronie’s disease can cause penile pain and discomfort, reduce the quality of erections, and make sexual intercourse difficult or painful. It can also create significant psychological strain for both men and their sexual partners.
Unlike congenital penile curvature, which is present from birth, Peyronie’s disease develops later in life. Some men experience pain when symptoms first appear.
The severity of curvatures varies, from a slight bend to more significant curves greater than 90 degrees. In severe cases, scar tissue can lead to penile shortening, making sexual intercourse challenging or even impossible.
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 can vary greatly among men. Research shows that most men will experience a resolution of penile pain over time, even without treatment.
When it comes to penile curvature, about 12% of men report improvement after one year without treatment, while 21-40% see no change, and 48-76% experience worsening curvature.
Treatment options are available that may help reduce curvature and pain, as well as improve sexual function.
The underlying cause of Peyronie’s disease is not yet known and is actively being researched in labs around the world. The proximate cause of penile curvature is the Peyronie’s plaque (scar tissue).
Normally, when the penis transitions from a flaccid to an erect state, a series of neurochemical reactions cause more blood to flow into the penis than out. For this to happen, the smooth muscle in the penis and the tunica albuginea (the lining of the erectile chambers) must relax and expand.
In Peyronie’s disease, the plaque prevents the tunica albuginea from stretching and expanding like the rest of the penis. As a result, during an erection, the non-expanding plaque causes the affected section to be shorter than the opposite side, leading to curvature. Similarly, as the penis expands in girth, the plaque may restrict expansion, causing indentations, narrowing, or tapering.
Research has suggested these agents as possible causes of plaque or scar formation in the penile shaft:
In most cases, based on medical history and physical examination, the doctor can diagnose Peyronie’s disease. The plaque or site of fibrosis can often be palpated when the penis is flaccid, but accurate assessment of penile curvature and deformities requires an erect penis.
In most cases, our doctor will perform a penile curvature assessment by inducing an erection with medication and conducting a detailed evaluation of the abnormalities.
Peyronie’s disease treatments can include shockwave therapy for pain reduction, penile injections and surgical procedures.
The goal of most treatments for Peyronie’s disease is to prevent further progression, maintain or improve sexual function, relieve penile pain, and straighten the curvature as much as possible.
Your doctor will carefully evaluate your case and recommend the best treatment plan for you.
RevibeMD is a procedural clinic offering emerging therapies for Peyronie’s disease and erectile dysfunction. Please note that treatments at RevibeMD are not covered by provincial insurance plans and should be considered as an additional option alongside other treatments not available at 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 who are not candidates for other therapies and are experiencing both psychological and functional challenges due to Peyronie’s disease, surgery may be considered.
The type of surgery depends on the specific nature of the curvature, deformity, and baseline erectile function. If surgery is appropriate, your doctor will discuss the available options, which generally include::
Patients should focus on improving their vascular and aerobic health. Regular exercise and a balanced diet are essential. Lifestyle changes may help a man achieve an erection more easily, allowing him to continue enjoying sexual activity even with Peyronie’s disease. Some lifestyle changes to consider include:
A man may also benefit from counseling to address stress, anxiety, or depression. While these lifestyle changes may not directly affect Peyronie’s disease, they can help improve sexual confidence and reduce concerns about erectile dysfunction, making it easier to enjoy intimate moments without worry.
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