What is Peyronie’s Disease?

Peyronie’s disease is a term that is used to describe curvature of the penis. It presents in varying degrees from slight, not bothersome curvature, to severe curvature that impairs or prevents sexual intercourse. This condition may be associated with erectile dysfunction.

What Causes Peyronie’s Disease?

Peyronie’s disease occurs when scar tissue builds up within the penis causing it to bend or shorten over time. This is the result of sustained trauma to the penis, for example, a sudden bend of the penis during sexual intercourse or attempting to have sex with a partial erection.

The urologist will ask questions to categorize the stage of the Peyronie’s disease, whether acute and chronic. In the acute phase, the patient usually experiences pain with erections, this can be very uncomfortable for the patient. At this time, the scar tissue is changing the appearance of the erect penis. Men may also notice curvature, shortening or even a hinged appearance of the penis. This phase can last a few months. During the chronic phase, the pain typically is not present, and it is thought that the plaque causing curvature is stable, which is the appropriate time for intervention.

Symptoms of Peyronie’s Disease

In addition to curvatures or indentations of the penis, other symptoms can include:

· Shrinkage or shortening of the penis

· Painful erections

· Inability to penetrate during intercourse

How is Peyronie’s diagnosed?

If you believe you have Peyronie’s disease, you should schedule an appointment with a urologist, who will start off by performing a physical exam. During the physical exam, your urologist may take measurements of your penis to determine the length of the penis and the extent of scar tissue present. Your urologist will also want to see the severity of the curvature during an erection.

How is Peyronie’s disease treated?

There are many options on the internet that claim to be effective for Peyronie’s disease, but you should review your options with your urologist and discuss the latest evidence-based practices. This collaborative engagement can save you time and frustration in the long run.

• Lifestyle Changes - If you are experiencing erectile disfunction related to Peyronie’s disease, your doctor may also recommend lifestyle changes to help with erectile dysfunction.

• Penile Rehabilitation - Your urologist may also suggest penile rehabilitation exercises with a penile traction device. During traction therapy the patient uses a self-applied device on their penis, which can help stretch the penis to help regain length lost due to scar formation. This is the least invasive option, and research has proven this option is effective, especially for patients who can commit to the exercises.

• Medication - Most oral medication has been shown to be ineffective. Medication that is injected into the penis has been shown to be most effective in reducing the curvature of the penis. Currently, the only FDA-approved medication to treat Peyronie’s disease is Xiaflex injections. This medication will help break down the scar tissue and decrease the degree of penile curvature. It is very important to remain abstinent during this treatment as there is risk of penile rupture. Other injection options include verapamil and interferon with varying results.

• Surgery - For severe cases surgery may be the only option. Surgery options include:

1. Plication – The surgeon places sutures to counteract the forces drawing the penis to one side in an effort to straighten the penis.
2. Excision and grafting – The surgeon will remove part of the skin and fill the space with a graft. This can help with curvature. Additional care is taken to minimize increased risk of erectile dysfunction.
3. Penile implants – For men with significant Peyronie’s disease and erectile dysfunction, a penile prosthesis will work to restore rigidity and length sufficient for intercourse. Patient and partners are often satisfied with the results of a penile prosthesis (>85 %)

If you have questions or concerns about Peyronie’s disease, schedule an appointment with an Ochsner Urologist.