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Doctor-Evaluating-Peyronie's-Disease

Peyronie's disease is a deformity of the penis caused by the formation of scar tissue.

Accumulated scar tissue causes the penis to bend when erect. While it's still possible for men with this abnormality to have intercourse, the deformity may cause discomfort. If the condition is severe, however, it may affect self-esteem and contribute to relationship issues.

For men with related erectile dysfunction (ED) or a problematic deformity, surgery to restore the normal shape of the penis may be recommended.

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Causes of Peyronie's Disease

An exact cause of this deformity isn't known. It's believed to be related to some type of trauma, such as a severe impact or bending of the penis beyond it's normal range of flexibility. In some instances, a man may not be aware of the injury that could have contributed to Peyronie's disease. Other times, the shape of the penis may slowly change over time. There may also be a genetic link and a connection with men who also have Dupuytren's contractures, a condition where scarring in hands affects fingers.

Symptoms and Signs

Some men will notice visible differences in the shape of the penis immediately after some type of trauma. In other cases, the hardened plaque may cause increasingly noticeable discomfort when the penis becomes erect spontaneously, which normally happens about 4-5 times a night for most men, or during sexual interactions. Scar tissue sometimes develops in other areas of the body as well. The deformity is not noticeable when the penis is not erect.

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Evaluation and Diagnosis

Most men will notices signs of the deformity themselves. Diagnosis may involve an examination of the hardened tissue. For times when Peyronie's disease is not confirmed during an initial examination, a biopsy may be done to determine if the skin abnormality is related to penis cancer or another issue. Image tests might also be ordered to examine penile tissues in greater detail.

Treating Peyronie's Disease

If Peyronie’s disease is mild, the deformity may eventually correct itself. Even when there is recurring discomfort, it's rarely severe enough to significantly affect quality of life. For this reason, the general recombination for many patients is to wait for a year or so before considering surgery to see if the deformity becomes less problematic. Non-surgical treatment options include oral medications such as potassium para-aminobenzoate or an injection directly into the affected area of the penis.

Surgical Treatment Options

Surgery is usually only considered if discomfort is severe or making it difficult or impossible to have intercourse. With penile plication surgery, sutures are used to work against the curvature and restructure the penis. Plaque excision and grafting surgery involves removing the plaque and performing a tissue graft. If Peyronie's disease is combined with ED, penile implant surgery may be recommended.

Peyronie's disease is not a preventable condition. But men may be able to reduce the risk of experiencing this deformity by making an effort to avoid direct trauma to the penis or groin that sometimes contributes to the development of this disease. What a urologist can do is help patients explore their options to determine whether it makes sense to opt for ongoing observation or consider corrective surgery.

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faculty_gelman
Joel Gelman, M.D.
Male Urology
HS Clinical Professor-VCF
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Faysal A. Yafi, M.D., F.R.C.S.C.
Male Urology
HS Assistant Clinical Professor, Medical Director Men’s Health Program

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