Peyronie’s Disease affects approximately one in 10 men, yet many suffer in silence and neglect seeking the care they need due to embarrassment or confusion about their symptoms. To destigmatize men’s sexual health issues and provide support to those suffering from this disease, this guide offers a thorough understanding of the condition, its causes, and the various treatment options available to those affected.
What is Peyronie’s Disease?
Peyronie’s Disease is a connective tissue disorder characterized by the formation of fibrous scar tissue (plaque) within the tunica albuginea of the penis. This scar tissue can cause:
- Changes in penile shape during erection.
- Curvature of varying degrees.
- Shortening of the penis.
- Pain during erections or sexual activity.
- Erectile dysfunction due to venous leakage.
Two Phases of Peyronie’s Disease
- Acute phase. This period of active inflammation typically lasts six to 12 months. During this phase, the development of plaque occurs, which can lead to penile curvature and deformity. Pain is most common during this period and treatment interventions are most effective during this initial stage.
- Chronic phase. This phase begins when symptoms stabilize. Plaque becomes more stable and curvature typically stops progressing. Pain often improves and treatment approaches may need to be more aggressive.
Understanding the Causes
While the exact cause of Peyronie’s Disease isn’t always clear, several factors may contribute to the development of this condition.
Primary Risk Factors
Some of the main risk factors for developing Peyronie’s Disease include:
- Trauma or injury during sexual activity.
- Repeated microtrauma over time due to weaker erections.
- Genetic predisposition.
- Age-related tissue changes.
- Autoimmune conditions.
- Certain medications.
- Previous pelvic or penile surgery.
Contributing Factors
Other contributing factors can include things like:
- Smoking.
- Diabetes.
- Cardiovascular disease.
- Elevated blood pressure.
- Connective tissue disorders.
Recognizing the Symptoms
Physical Signs
Several physical symptoms may manifest, including:
- Curvature of the penis during erection.
- Hard lumps or bands of tissue under the skin.
- Narrowing or indentation of the shaft (hourglass deformity).
- Length reduction.
- Difficulty achieving or maintaining an erection.
- Pain during erections or at rest.
Psychological Impact
Those with Peyronie’s Disease may also begin to struggle with:
- Anxiety about sexual performance.
- Depression.
- Relationship stress.
- Reduced self-esteem.
- Sexual avoidance.
- Partner concerns.
Diagnostic Process
Initial Evaluation
A proper diagnosis typically involves:
- Medical history review. During this initial intake, your urologist may ask you about the onset of symptoms, progression timeline, previous injuries, family history, current medications, and your overall health.
- Physical examination. During the physical examination, patients can expect an assessment of plaque location and size, evaluation of tissue characteristics, measurement of flaccid length, and a check for other physical abnormalities or related conditions such as Duputren’s contracture.
- Specialized testing. Some testing may be required, including penile ultrasound, artificial erection testing, photograph documentation, plaque calcification assessment, MRI and vascular flow studies.
Measuring and Documenting Progress
During the diagnostic process, patients may also undergo measuring and documenting, which typically involves evaluation of:
- Degree of curvature measurement.
- Erectile function.
- Pain scale.
- Impact on sexual activity.
- Quality of life.
Treatment Options
Conservative Management
The following are appropriate during the acute phase or for mild cases:
- Oral medications (Pentoxifylline, colchicine and PDE5 inhibitors like Cialis).
- Vitamin E supplementation.
- Pain management with anti-inflammatories.
- Monitoring for stabilization.
Non-Surgical Interventions
Injection Therapy
- Collagenase Clostridium Histolyticum (Xiaflex). An FDA-approved treatment that involves a series of injections, combined with penile remodeling done by an expert penile surgeon. This option is best for specific curvature patterns.
- Verapamil or Interferon injections. This injection therapy may help reduce plaque formation and can improve pain symptoms. Multiple treatment sessions are required and should only be performed by a urologist.
Traction Therapy
This form of therapy typically includes:
- Daily stretching protocols.
- Vacuum therapy.
- Penile modeling exercises.
- Combined approach with other treatments.
Surgical Options
Reserved for stable disease (typically after 12 months) with severe curvature or erectile dysfunction:
- Plication procedures: Involve shortening the longer side of the penis to correct curvature, allowing it to maintain erectile function with minimal risk of complications. However, this procedure may result in some loss of penile length, something many men are not willing to accept.
- Plaque incision/excision with grafting: Addresses penile curvature by either removing or incising the plaque while preserving the length of the penis. This option involves a more complex recovery process and carries a higher risk of complications compared to plication.
- Penile implant surgery: Typically recommended for cases with severe erectile dysfunction. This procedure not only straightens the penis but also provides rigidity, offering the highest satisfaction rates among surgical options and serving as the most definitive solution for severe cases.
Living with Peyronie’s Disease
Lifestyle modifications can significantly enhance sexual health and treatment outcomes. Quitting smoking, improving cardiovascular health, reducing stress, engaging in regular exercise, and maintaining proper nutrition all contribute positively to overall well-being and sexual function. It can also improve surgical outcomes.
Communication strategies are also essential in managing sexual health issues effectively. Open dialogue with partners, setting realistic expectations, understanding treatment timelines, and building support networks can create a more supportive and understanding environment.
Mental health considerations are equally important, as mental well-being is closely linked to sexual health. Counseling options, support group participation, relationship therapy as needed, and stress management techniques can help individuals and couples navigate the emotional aspects of treatment and recovery.
Future Developments
Emerging Treatments
- Stem cell therapy research
- New injection protocols
- Advanced surgical techniques
- Novel drug development
Ongoing Research
- Genetic factors
- Prevention strategies
Prevention and Risk Reduction
Prevention and risk reduction strategies can play a vital role in maintaining sexual health and reducing the risk of complications. Protective measures, such as practicing proper sexual techniques, avoiding injuries, maintaining regular health checkups, and seeking early intervention when symptoms appear, are essential steps in preserving normal sexual function.
Health optimization is also crucial, as managing factors like blood pressure, diabetes, and weight can positively impact sexual health. Regular exercise and a balanced, nutritious diet further support overall wellness, creating a strong foundation for long-term sexual health and vitality.
Understanding Long-Term Outlook
Prognostic Factors
- Age at onset
- Severity of curvature
- Plaque characteristics
- Treatment timing
- Overall health status
Success Metrics
- Curvature improvement
- Pain reduction
- Sexual function restoration
- Quality of life enhancement
- Relationship satisfaction
Get the Care You Need
Peyronie’s Disease, while challenging, has numerous treatment options available. Success rates are highest when the condition is diagnosed early and treated appropriately. Understanding your options and working with experienced urologists like those at Obsidian Men’s Health is crucial for achieving optimal outcomes. Urologists are the only experts in Peyronie’s disease.
If you’re living with Peyronie’s Disease or are experiencing symptoms of this condition, schedule a consultation with our team.
