Symptoms of Peyronie`s Disease
Symptoms of Peyronie`s Disease are very specific. They include plaques on the penis, its curvature, and painful erections. Symptoms can be more or less significant, while plaques, in case the disease is congenital, may not appear at all. In other cases, plagues’ size can range from a few millimeters to several centimeters. Sometimes they cover the entire surface of the penis. Often the first symptom of the disease is painful erections.
It is the plaques that lead to the deformation of the penis and a change in its shape. Sometimes the change in form becomes the most obvious symptom of the disease. The penis can take the form of a sandglass or have a bottleneck-like narrowing.
What causes Peyronie`s Disease?
The real causes of this condition are still not well-known. It is believed that the fibrous plaque can develop after repeated physical traumas (like hitting or bending after extreme sex, hard physical activity, or any accident) that may cause bleeding inside the genital organ. Often, such micro-injuries are left unnoticed. Some scientists suppose that this disease is linked to genes.
How is Peyronie`s Disease related to Erectile Dysfunction?
It is believed that the disease manifests itself after some kind of physical trauma. After such an injury, the scar tissue starts forming in a disorganized manner, possibly resulting in a perceptible nodule or development of penile deformation. A man’s penis contains two sponge-like chambers (corpus cavernosum) that feature numerous tiny blood vessels. Each of these chambers is placed in a sheath of tunica albuginea (a sort of tissue) which can stretch when an erection happens.
When a man is sexually excited, blood circulation increases in the corpus cavernosum, making them fill with blood and, thus, causing an enlargement of a penis (an erection). But is a man suffers from Peyronie’s disease, the part of a penis with a scar tissue cannot enlarge, which forces the penis to bend and disfigure, causing an unbearable pain and making an intercourse simply impossible.
Description of Peyronie`s Disease
The onset of such a disease is quite acute. Inflammation in the tunica albuginea of corpus cavernosum results in the development of plaques and thickening on certain penile areas, at last, leading to a penis deformation. Typically, the process of plaques formation lasts several months, after which, the process stabilizes.
But the disease does not limit itself to a single change in the shape of the penis, leading to erectile dysfunction. In some cases, arterial and venous patency may be compromised, promoting the development of arterial insufficiency of the penis.
The condition was named in honor of François Gigot de la Peyronie, a French surgeon who was the first to describe this phenomenon in the XVI century but he could not fully explain the mechanisms of its development. They are not very clear even today. It is only known that the disease mostly affects men of 30-60 years old leading an active sexual life.
The disease is caused by plaques in tunica albuginea of cavernous bodies and benign indurations the back of the penis, the urethra, and on the sides of the penis. And the cause of these changes is not well-established yet, but it is believed that micro-traumas are the culprit of this. However, in some cases, Peyronie’s Disease is a congenital condition. Then its cause is the hypoplasia of the fibrous tunic or a short urethral canal. There are no plaques with congenital pathology, and the bend itself is not significant, and does not require any treatment.
Peyronie`s Disease is quite a rare condition and is diagnosed in less than in 1% of middle-aged men. At an early age, the disease does not develop, and it is not commonly found in men at a young age. As a rule, the ailment strikes men between 40-60 years.
The deformation of a penis is caused by a connective tissue which forms in larger quantities compared to a normal state. The curvature of the penis happens during sexual excitement, making an intercourse practically impossible. The disease has two stages: an acute and chronic with the first stage is followed by the second.
Generally, the acute (active) phase lasts 6-12 months. This period is characterized by a severe pain during erections, a slight bend of the penis, and the first signs of plaques. If during this period, the disease does not pass, meaning, the thickening inside the penis shaft has not disappeared by its own, a conservative treatment is recommended. The sooner it starts, the better the result is.
If the disease is accompanied by sharp pains or if the deformation is profound, it is advisable to have a surgical management. A surgery is recommended in a case then the therapeutic treatment fails to help. The chronic stage of the disease develops when the plaques stop growing, and the bend achieves the maximum size, triggering an erectile dysfunction.
How is Peyronie`s Disease diagnosed?
An urologist determines the location of a plaque and the level of penis’s deformation after examination by touch. Sometimes, a patient is asked to bring a photo of an erected penis to specify the severity of deformation. An ultrasound investigation is more effective because it helps to discover the illness at the very first stage.
Peyronie`s Disease treatment
There are several ways to treat Peyronie`s Disease, however, it also can pass off without any medical intervention. The treatment is chosen depending on the degree of penis damage, its deformation, and associated complications. If the penis is slightly bent when erected, the therapeutic management is not required. Thoroughgoing treatment is possible only in the case, and then the disease gave rise to erectile dysfunction.
The treatment can be non-operative and surgical. The former one involves anti-inflammatory agents and the drugs which prevent the development of fibrotic tissue. These drugs are used in a form of injections. The doctor may also prescribe drugs which fend off calcification of affected areas. A beneficial effect is provided by physiotherapeutic procedures, X-ray therapy, and laser therapy with the helium-neon laser. Patients are also prescribed to take vitamin A and E supplements. Ultrasonic methods are also used. But if the areas of hardening are too large, they are removed surgically. Surgical treatment not only corrects the curvature, but also removes the thickened nodes. The surgery has some complications including the formation of a scar, which in the future can lead to a decrease in the sexual power and even its complete disappearance.
The method of surgical intervention consists either of:
- applying folds on the side, which is opposite to the curved line of the penis,
- or closure of the tissue, which shortens the penis.
In the second variant, complications are less common. With a large deformation (more than 45 degrees), the tunica albuginea of corpus cavernosum is excised in the form of ellipses, and on the other side, the penis is sutured. If these methods are not suitable for any reason, for example, if the patient is not satisfied with the shortening, the operation is performed with through the use of plastic surgery after the plaque is excised. If the disease is severe and has already caused erectile dysfunction, then penile prosthesis and penile implantation may be a way out.
Prophylaxis of Peyronie`s Disease
Since the main cause of the disease is micro-traumas, obtained in a process of an extreme or too active sexual intercourse, then the prevention of penis deformation is a calmer sex with avoidance of difficult positions, and the refusal of having sex in a state of alcoholic or narcotic intoxication.
Peyronie’s disease is not obligatory a result of minor injuries to the penis. Still, there are some factors which can contribute to improper wound healing after traumas and scar tissue overgrowth, thus, increasing the risk of Peyronie’s disease.
These factors include:
- Connective tissue disorders
- Prostate surgery
Complications of Peyronie’s Disease
These may include:
- An inability to conduct a quality sexual intercourse
- A difficulty in obtaining and keeping an erection
- Anxiety and fear of an intercourse, the complex of inferiority due to the shape of a penis
- Problems with a relationship with a sexual partner
- A difficulty with fathering a child
Peyronie`s Disease FAQs