Peyronie's disease
Peyronie's disease is a condition characterized by the development of fibrous scar tissue (plaque) under the skin of the penis, leading to abnormal curvature during erections. This curvature can cause pain and may interfere with sexual function.
Symptoms:
Noticeable bend or curve in the penis during erections.
Pain during erections or sexual activity.
Palpable lumps or hard areas under the skin of the penis.
Shortening or narrowing of the penis.
Causes:
The exact cause of Peyronie's disease is not fully understood, but it is believed to result from repeated injury or trauma to the penis, leading to scar tissue formation. Genetic factors and certain connective tissue disorders may also contribute to its development.
Diagnosis:
Diagnosis typically involves a physical examination to feel for scar tissue and assess the degree of curvature. Imaging tests, such as ultrasound, may be used to evaluate the plaque and blood flow in the penis.
Treatment:
Treatment options depend on the severity of the condition and may include:
Medications: Oral or injectable drugs to reduce pain and plaque formation.
Traction Therapy: Use of devices to stretch the penis and improve curvature.
Surgery: Procedures to remove or alter the scar tissue, or to implant devices that help straighten the penis.
Early consultation with a healthcare provider is important for effective management of Peyronie's disease.
Treatment
Non-Surgical Treatments:
Medications:
Collagenase Clostridium Histolyticum (Xiaflex): This FDA-approved injectable treatment targets and breaks down the collagen in the plaques, reducing penile curvature. It's typically recommended for men with a curvature between 30 to 90 degrees. The treatment involves a series of injections directly into the plaque, followed by penile modeling exercises.
Verapamil: Originally used to treat high blood pressure, verapamil can be injected directly into the penile plaque. Some studies suggest it may reduce pain and curvature, though more research is needed to confirm its efficacy.
Pentoxifylline: This oral medication is believed to inhibit inflammatory processes that lead to scar formation. Clinical trials have shown a modest effect, with about a 40% chance of improving the plaque after six months of therapy.
Traction Therapy:
Penile traction devices are used to gently stretch the penis, which may improve curvature and preserve or increase length. Traction therapy is recommended in the early phase of Peyronie's disease and may need to be worn for as little as 30 minutes or up to 3 to 8 hours a day, depending on the specific device.
Surgical Treatments:
Surgery is generally considered when non-surgical treatments are ineffective, or if the curvature is severe and hinders sexual function. Surgical options include:
Plication: Shortening the unaffected side of the penis to straighten it. This method may result in a slight reduction in penile length.
Plaque Incision or Excision with Grafting: Removing or cutting the plaque and covering the defect with a graft. This approach is typically used for more severe curvatures.
Penile Implants: For men with both Peyronie's disease and erectile dysfunction, penile implants can straighten the penis and restore erectile function.