PEYRONIE’S DISEASE
Peyronie’s disease is a condition marked by the growth of scar tissue, called plaque in the soft tissue of the penis.
- The human penis is an external male organ that additionally serves as the urinal duct.
- The main parts are the roots, the body and the epithelium of the penis including the shaft skin and the foreskin covering the glans penis.
- The body of the penis is made up of three columns of tissue: two corpora cavernosa that contain much tiny blood vessel located on the dorsal side and corpus spongiosum between them on the ventral side.
- Each of the corpora cavernosa is encased in a sheath of elastic tissue called tunica albuginea, which stretches during erection
- The scar tissue accompanied by Peyronie’s disease forms in the tunica albuginea.
- This causes pain, abnormal curvature, erectile dysfunction, loss of girth and shortening.
- The condition is estimated to affect about 10% of men and it becomes more common with age.
- Peyronie’s disease can cause complications such as the inability to have sexual intercourse, difficulty achieving or maintaining an erection, and even anxiety or stress.
CAUSES
Doctors don’t know exactly why Peyronie’s disease happens, but a number of factors appear to be involved.
It is believed that the condition results from repeated trauma or injury to the penis usually during sexual intercourse or physical activity such as athletic activity, or as the result of an accident. This can cause bleeding and subsequent scar tissue buildup.
In some men, the condition comes on gradually and is not related to any injury or trauma. Investigations are ongoing to know if the disease might be linked to an inherited trait or certain health conditions.
SYMPTOMS
- Hardened, big, cord-like scar tissue (plaque) that can be felt under the skin of the penis.
- Pain
- A significant curvature to the penis. The penis may be curved upward, downward, or bent to one side. In some cases, the scar tissues sometimes cause an indentation or an hourglass appearance, with a tight narrow band around the shaft.
- Shrinkage or shortening of the penis.
- Erection problems
DIAGNOSIS AND TREATMENT
In diagnosing the condition, a physical examination is often sufficient to identify the presence of scar tissue in the penis. During the physical exam, the doctor will palpate your penis when it is not erect to identify the location and the amount of scar tissue.
The doctor may also measure the length of your penis and if the condition continues to worsen, the initial measurement will help to know if your penis has shortened.
To determine the degree of curvature, or other details that may help with treatment, the doctor may request for a picture of your erect penis taken at home.
Ultrasound tests may be used to check for penis abnormalities such as the presence of scar tissue, or blood flow to the penis.
TREATMENT
Treatment option may include medication and surgery.
Medications may include:
- Collagenase clostridium histolyticum which is the only FDA-approved medication for Peyronie’s disease. The drug works by breaking down the excess collagen in the penis that causes the condition.
- Verapamil
- Interferon
Surgical options may include:
- Suturing the unaffected side, this procedure may result in straightening of the penis. An example of this type of procedure is the Nesbit plication.
- A penile prosthesis may be appropriate in advanced cases.
Counselling – because of the deformity and the erectile dysfunction that occurs as the result of the condition, it is not uncommon for men with Peyronie’s disease to exhibit depression or withdrawal from their sexual partner. Counselling may help men be able to live with the condition.