Peyronie’s Disease or penile curvature is a buildup of fibrous “plaque” or scar tissue within the elastic covering (tunica albuginea) of the erectile tissue of the penis. The name “Peyronie’s Disease” is derived from the physician Francois Gigot de la Peyronie, personal physician to King Louis XV of France. De la Peyronie wrote an authoritative description of the disorder in 1743. Peyronie’s disease can be found in up to 9% of men between the ages of 40 and 70. The condition is rare in young men but has been reported in men in their 30s.
The actual prevalence of Peyronie’s disease may be much higher than 9% due to patient embarrassment and limited reporting by physicians. The cause of Peyronie’s disease is not entirely clear. Many researchers believe the plaque of Peyronie’s disease can occur after the penis has been hit or bent, which causes bleeding inside the penis. In addition, the elastic in the layer of the two erectile chambers (or cylinders) in the penis may become more brittle over time, which can also lead to an injury.
Symptoms of Peyronie’s disease may develop slowly, or can appear overnight. In severe cases, the plaque makes the penis less flexible. This can cause pain and may force the penis to bend or curve during an erection. Common symptoms include:
- A lump or thickening along the shaft of the penis that is most noticeable when the penis is soft (flaccid).
- A bent or curved appearance of the penis that is most noticeable when the penis is erect.
- A painful erection. Some men do not have pain with an erection but have tenderness when the lump along the side of the penis is touched.
- An inability to keep an erection.
- An inability to achieve penetration during intercourse.
Stages Of Peyronie’s Disease
Peyronie’s disease is usually divided into two stages:
The acute phase The most common symptoms of this phase are painful erections and a change in the curve of the penis.
The chronic phase The curve of the penis may be the only symptom of this phase. Pain, if present during the acute phase, usually gets better or goes away completely.
Peyronie’s disease is usually diagnosed using a medical history and physical exam. Your doctor will ask you questions about when you first noticed your symptoms and whether the symptoms were gradual or sudden. This will help determine which stage of Peyronie’s disease you are experiencing. Because symptoms of Peyronie’s disease are usually most noticeable when the penis is erect, your doctor may inject a drug into your penis to make it erect. This will help your doctor see where the erectile tissue is scarred.
In about 13% of cases, Peyronie’s disease goes away without the need for treatment. Treatment of Peyronie’s disease is based on a number of factors including the degree of penile curvature, severity of penile shortening, the presence of penile narrowing, and whether erectile dysfunction is present. Sometimes the patient is advised to delay treatment since the condition can resolve itself. If treatment is necessary, some treatments include:
- Verapamil injections: In this ongoing treatment, the physician injects verapamil directly into the scar tissue through a very small needle
- Extenders: The physician may stretch the penis with a vacuum device
- Surgery: Surgical options include removing the scar tissue or shortening the unaffected side of the penis (plication).