Peyronie’s disease, or curvature of the penis during an erection, is a rare and painful condition that mainly affects men between 40 and 60 years old. The curvature occurs as scar tissue forms, first as inflammation and then as a small bump or bumps below the skin on the upper midline of the penis. The curvature can be as slight as 10 degrees or so severe that the penis is in a “U” shape.
The specific area that Peyronie’s disease affects is the tunica albuginia, or the elastic coverings that surround the corpora cavernosa, the chambers within the penis that fill with blood during an erection.
WHAT ARE THE SYMPTOMS?
A man’s first indication that he has Peyronie’s is pain during erection or tenderness at the site of the plaque from scar tissue and inflammation. Other patients notice a sudden curvature to the penis where none had existed previously.
CAUSES AND RISK FACTORS
Physicians do not understand Peyronie’s cause. Trauma to the penis during intercourse or a loss of elasticity from age may cause the condition. Peyronie’s is also likely to be linked to a connective tissue disorder that may be affecting another area of the body.
DIAGNOSIS
To diagnose Peyronie’s disease, the physician will perform a history and physical examination, which includes manipulation of the penis. Other tests used may include ultrasound and magnetic resonance imaging.
TREATMENT APPROACH
Because Peyronie’s so frequently resolves itself in months, treatment for the condition isn’t always necessary. Treatment may not be considered until the curvature is severe enough to preclude sexual intercourse. Non-surgical therapies that are available include topical or oral vitamin E or colchicine and injections into plaque lesions of verapamil, calcium channel blockers, or potassium aminobenzoate.
Surgery is the best means to correct Peyronie’s, particularly if the curvature precludes sexual intercourse, but it can damage nerves and cause erectile dysfunction. One-third of Peyronie’s patients opt for one of the following surgeries:
- Excision grafting;
- Incision grafting;
- Plication; or
- Prosthetic implantation.
