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Peyronie’s Disease

Peyronie’s disease causes the penis to bend and become painful during erection. Peyronie’s disease is most often caused by a minor injury to the penis, which causes scar tissue (plaque) to form inside the penis. Typically, curvature associated with Peyronie’s disease is much more pronounced than normally occurring curvature. This may cause pain, abnormal curvature, loss of girth and/or shortening of the penis, as well as erectile dysfunction or indentation.

Statistics indicate that Peyronie’s disease occurs in about six out of 100 men between the ages of 40 and 70. It can occur, rarely, in younger men.

Causes of Peyronie’s disease

Peyronie’s disease is most often caused by minor trauma to the penis. However, researchers also believe that Peyronie’s disease may have genetic or environmental contributors as well. Men who have a close family member who has experienced Peyronie’s disease are more likely to develop the condition. Men with high blood sugar or diabetes, who use tobacco, or who have had past pelvic-area trauma also are at higher risk of developing Peyronie’s disease.

Diagnosis

Peyronie’s disease can be diagnosed through physical exam and ultrasound images of the erect penis.

Treating Peyronie’s Disease

Some men who present with the symptoms of Peyronie’s disease experience improvement without treatment, while other men have lived with the condition for months or longer and require more interventional treatment.  If the curvature of the penis does not correct itself over time, it’s important to discuss treatment options with a urologist. Surgery is considered the gold standard therapy, but other treatment options may help.

Surgery

When the deformity or pain caused by Peyronie’s disease is severe and the condition persists for a year or more and does not respond to other treatment, surgery to correct the penis curvature may be an option. The specialists at Colorado Urology offer the most effective surgical procedures for Peyronie’s disease, including:

  • Suturing (plicating) the unaffected side. A variety of procedures can be used to suture the side of the penis that does not have scar tissue. Suturing straightens the penis, although it may result in actual or perceived shortening.
  • Incision or excision and grafting. With this type of surgery, the surgeon makes one or more cuts in the scar tissue, allowing the sheath to stretch out and the penis to straighten. The surgeon then may remove some of the scar tissue, and sew tissue into place to cover the surgical area. This procedure is generally used in cases of severe curvature or deformity. Side effects may include erectile dysfunction.
  • Penile implants. Penile implants, also called penile prostheses, are an effective treatment for erectile dysfunction, but they can also be used to treat Peyronie’s disease. Surgically inserted implants replace the spongy tissue that fills with blood during an erection. The implants might be semirigid — manually bent down most of the time and bent upward for sexual intercourse. Another type of implant is inflated with a pump implanted in the scrotum. If the implant alone is not completely effective, it may be combined with tissue grafting. Learn more about the benefits of penile implants, including invisibility, permanence and high patient satisfaction.
Medical Management

Although research overall has been inconclusive, some patients report symptom relief from medications including vitamin E supplements, potassium amino-benzoate (sold under the name Potaba); and an anti-swelling agent called colchicine.

  • Oral medication – Pentoxifylline is an oral medication used for Peyronie’s disease. When taken for several months, the medication may reduce the amount of scar tissue, though exactly how it works isn’t understood.
  • Injections – For some patients, medications injected directly into the affected area can help fix penis curvature associated with Peyronie’s disease. Depending on the therapy, you might be given a local anesthetic before the injection. Many injected medications are administered multiple times over several months. These medications may also be used in combination with oral drugs. Injectable therapies include:
    • Collagenase. The only medication approved by the U.S. Food and Drug Administration for treatment of Peyronie’s disease is collagenase clostridium histolyticum, sold under the brand name Xiaflex. This therapy has been shown to improve penis curvature by breaking down the production of collagen, a protein that might be a key factor in the formation of Peyronie’s disease.
    • Verapamil. Typically used to treat high blood pressure, Verapamil also appears to disrupt the production of collagen.
    • Interferon. This is a type of protein that appears to disrupt the production of fibrous tissue and helps break it down. One placebo-controlled trial showed improvement using this therapy compared with placebo.

Symptoms of Peyronie’s disease include:

  • Abnormal curvature of the penis
  • Loss of girth or shortening of the penis
  • Painful erections
  • Indentation of the penis
  • Difficulty with intercourse
  • Discomfort for your partner
  • Erectile dysfunction
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