What is Peyronie’s Disease?
Peyronie’s Disease, also known as Induratio Penis Plastica or IPP, is a condition that affects the male penis. This condition leaves a male with fibrous plaque nodules beneath the fibrous sheath that surrounds the shaft of the penis. It was first discovered in 1587 but did not get its current name until more than 150 years later when King Louis XIV’s surgeon, François Gigot de la Peyronie, described the cases of three men. It causes penile pain and bending of the penis in such a way that it becomes painful to perform sexual intercourse.
Can a child be born with this disease?
No. This disease usually affects men ages 40 and older but can be found in teenagers as well. There have been rare cases of men younger than 40 who have been affected with this disease but it is normally seen in older men. Some men are born with a natural curvature of the penis. This is not an indication that they will get or have Peyronie’s Disease. Some curvature of the penis is normal for many men however an indication of Peyronie’s is a cane like curvature with pain during erections.
Is Erectile Dysfunction a sign of Peyronie’s?
No. Peyronie’s should not be confused with any form of erectile dysfunction including enlarged prostate, impotence or any other form of ED. Although Peyronie’s can cause impotence there is no way of who will become impotent and who will dodge the bullet
How can you tell if you have Peyronie’s Disease?
Men who have Peyronie’s Disease will discover it as a small pea size lump below the surface of the penis. It can be painful to the touch and if left untreated causes distortion of the penis. There is typically no visible distortion or lumps to the flaccid penis. A good indication that you have Peyronie’s Disease is a painful erection, palpable scars and bending of the penis.
Do doctors know what causes Peyronie’s Disease?
Although the exact cause of Peyronie’s is not known it is believed that trauma or injury to the penis causes Peyronie’s Disease. Vigorous sexual intercourse can cause trauma or injury to the penis which in some instances does not heal properly.
Is the condition hereditary?
Others believe it is an inherited condition even though it is not thought to be a passable trait. However it is more prevalent in male family members with conditions such as Systemic Lupus Erythematosus or Dupuytren’s Contracture.
Is there any indication that it can be caused by a vitamin deficiency?
It has been speculated that it is caused by a vitamin E deficiency because some have gotten relief with the treatment of large doses of vitamin E. This is not recommended without the strict supervision of a physician. Taking extra vitamin E has proven in numerous studies that it has no effects on Peyronies.
Is diabetes an indication of Peyronie’s Disease?
Diabetes can lead to blood vessel damage. Diabetes can also cause gout which is crystallized uric acid within the joints. Because diabetes can cause crystallization and blood vessel damage, it is associated with Peyronie’s Disease.
Are there any signs that vascular inflammation can cause Peyronie’s?
There have been cases of severe vascular inflammation found in patients with Peyronie’s. This may be cause to examine the theory that vascular inflammation is a cause of the condition.
Do medications have any correlation to the condition?
Side effects of some anti-hypertension medications list Peyronie’s Disease as a possible side effect. One medication in particular is Inderal or Propanolol.
How do the fibrous nodules form?
It is believed that when trauma or injury occurs to the penis, an inflammatory reaction occurs. The damage to the penis can present itself as small tears in the Tunica Albuginea of the penis or as ruptured blood vessels. During the healing time, the tissue is so traumatized that it does not heal properly causing scarring or nodules. Once the inflammation begins the tissue begins a remodeling phase causing small nodules. Sometimes these nodules will not be visible to the eye or touch resulting in the patient not seeking medical treatment. Pain begins to occur during an erection and when the pain subsides, the remodeling of the tissue is complete.
Why is there bending of the penis with this condition?
Bending of the penis occurs when the scarring becomes so prominent that the tissue loses its elasticity. In some cases once the nodules are treated, the penis will reclaim its former shape. This is also what causes a portion of the pain, the inability for the Tunica Albuginea to stretch due to scarring or nodules.
How long is there between the forming of the nodules and distortion?
The nodules take a while to develop. It isn’t until after the nodules have developed that bending begins to become very evident.
Can the penis take on other shapes?
Yes. In extreme cases the nodules or scars may create a bottle-neck, collar-like or hourglass shape to an erect penis. In addition to this, the penis can remain limp or soft beyond the location of the nodule or scars leading to an inability to have sexual intercourse. In extreme cases of distortion, the erect penis becomes so distorted that when it becomes erect it takes the shape of the letter J or a corkscrew making intercourse impossible or at the very least extremely painful for both partners.
Can you have Peyronie’s Disease without having pain?
In some cases patients are totally unaware of the disease until they are examined for erectile dysfunction. The distortion of the penis or lumps are not visible during the early stages of the disease however, a painful erection is an indicator of the disease along with palpable scars or bending of the penis.
What if you find a small lump that is painful but there is no distortion or bending?
You still may have Peyronie’s Disease. You do not have to have all of the symptoms at the same time to be diagnosed with Peyronie’s Disease. If you notice a small lump on the penis shaft that is painful when touched, you should seek medical advice as this could be a sign of Peyronie’s Disease.
What is the severity of the pain?
The pain varies in severity from none at all to severe causing sleep to be impossible. The pain can also present itself at no other time than when the area is touched, come and go on its own or be a constant pain without being touched. Pain that gets worse is not usually from the disease worsening but from new injuries to the tunica Albuginea.
How long does the pain continue?
Studies show that after the initial formation of the scar and deformity, pain usually resolves itself and the process of the disease stabilizes within 12 – 18 months. However, this is when the chronic stage begins and once the disease begins the chronic stage, many believe there is no other recourse than surgery.
How many stages of Peyronie’s Disease are there?
There are two stages of Peyronie’s Disease; acute and chronic. Neither stage is set to a particular length of time, duration or intensity in pain or symptoms. The acute stage is the inflammation phase of the disease and is generally when most of the scarring and bending occurs. Some cases never progress past the acute stage and resolve itself without treatment. During the acute stage, some doctors recommend a wait and see period and others recommend treatment as early and aggressively as possible. Because there is no way to predict what Peyronies will do to the penis it is highly recommended to take urgent steps to treat it because time is of the essence.
When does the distortion usually occur with Peyronie’s Disease?
Distortion usually occurs within the first 12 – 18 months which is the final phase of the scar formations. The scar formations render major changes to the Tunica Albuginea and distortion usually becomes even more prominent. In a few cases the distortion changes little if at all.
Is there any chance that the scarring may become harder than normal?
Yes, in about one quarter of patients who exhibit symptoms, the scars may actually begin to calcify. In another one quarter of the patients it will calcify into a sort of bone type of formation. When the scarring reaches this point, it is unlikely that the condition will be changed with any type of treatment other than surgery. Some doctors believe treatment is still possible but treatments will take longer and must be treated as aggressively as possible.
How does the disease affect an erection?
Some describe the erect penis as looking like a cane handle. However it is when the scar surrounds the circumference of the penis causing a bottle neck deformity that the deformity begins to affect the erection process. When the penis is being filled during the erection process, blood is unable to travel past the bottle neck, leaving the distal or top portion of the penis flaccid. This makes penetration impossible and can cause pain to either or both partners.
Men generally pride themselves in their sexual abilities. Can this disease affect their psyche?
Absolutely, especially if they are finding themselves unable to get a full erection. Not only can Peyronie’s affect a man’s mental and emotional well being, it can also affect his partners as well. If you find that you have symptoms of Peyronie’s Disease, you should discuss this with your partner along with the possibilities of its effects. It is also recommended that should this become a problem between partners, counseling may be a good course of action.
What are the recommendations for treatment?
There are no set treatments for Peyronie’s Disease although some patients have obtained relief with some medications such as vitamin E, Potaba (Potassium Para Amino Benzoate), Colchicine – a medication used to treat gout, Verapamil as a direct injection or topical cream, Interferon, Collagenase which is an experimental medication that contains enzymes that literally digests the scars, Acetyl L-Carnitine, ED medications and supplements Like Viagra and VigRx and Mechanical stretching with Penis extenders Like Proextender. Some doctors may use a trial and error method to find the right combination of medicines for you given the fact that few doctors are familiar with Peyronie’s Disease and its treatments. This is the only way of know what will and will not work.
Does Peyronie’s Disease require surgery?
In some instances surgery may be required. Your doctor will determine if and when surgery is necessary according to four criteria; if the severity of the deformity interferes with sexual function, natural healing has not given relief, medical therapy has been used with no resolution and if there is worsening or no change after a period of time.
Are there risks to the surgery?
Of course every surgery, even the simplest ones, carries risks. If your doctor deems surgery necessary, then he is saying that there is no chance of reversing the loss of tissue elasticity within the penis. It is important to know that surgery cannot completely restore the penis to its former condition and in most cases the penis is generally left shorter than prior to surgery. The most common side effects of surgery are the loss of sensation in the penis and Erectile dysfunction. By losing sensation the possibility of having orgasms might be gone forever. If ED is present but without a loss of sensation one could still achieve orgasms outside of intercourse.
What is a Nesbit Procedure?
A Nesbit procedure is a procedure used to correct the bending of the penis by gathering the outer side of the bend. A length reduction is usually minimal and erectile dysfunction is less likely to occur. This is usually the first choice of procedures for Peyronie’s Disease and the best method to correct curvature.
What are tissue grafts?
Tissue grafts are thin layers of tissue taken from another site that is used to expand the scars without removing them. This procedure is used in correcting severe bending and diameter constriction to the penis.
What is a plaque incision with a saphenous vein graft?
This is when several cuts that are made within the plaque scar that lets the penis straighten. Then the cuts are covered with a graft of vein in order to close the incisions.
Why would a Peyronie’s Disease sufferer need implant surgery?
Implant surgery is used as a last resort for Peyronie’s Disease sufferers. They are used to correct erectile dysfunction, which is sometimes associated with Peyronie’s Disease, by inserting plastic cylinders that are either solid or inflatable into the corpora cavernosum of the penis.
Is Peyronies a Very Serious Health Issue?
Although Peyronies is not dangerous in the sense that cancer would be and that your life is not at risk it still remains serious enough to you especially if you plan to still have a sex life. Due to it’s unpredictable nature Peyronie’s should be tackled with the utmost urgency as soon as any of it’s symptoms appear. As a sufferer you have no way of knowing if Peyronies will wreak havoc with your penis thus destroying your sex life and possibly your intimate relationship. So the first thing you should do is to set up an appointment with a Urologist that is familiar with this disorder. Unfortunately sometimes you must wait for months to get an appointment for a first visit and that is time that is being wasted and could have been used for treatment. Peyronies has a much better prognosis if treatment is started from the onset. If you are worried you must go see a urologist ASAP as he might be able to prescribe you with Potaba, Colchicine, Tamoxifen or Topical Verapamil. Also keep in mind that many studies in Europe have shown that specially designed penis stretchers like Proextender should be part of any Peyronie’s treatment plan to stretch the scars and keep them from calcifying. Keep in mind don’t just use any stretcher as some of them can be very painful to use.