Peyronies Disease: When does a curve become a disease?

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Peyronies Disease: When does a curve become a disease?

Peyronies Disease

All men and their sexual partners are fully aware that every male penis has a curve, some slightly upwards, some to the left and some to the right. This slight curve is very normal and can add pleasure and be highly desirable for both the man and his partner.

This natural curve may become an issue when pain is experienced when the penis is erect or when the curve is so significant it is causing pain and discomfort to the man or his partner during sexual intercourse.

An extreme curve may be an indication of Peyronie’s disease. The disease can develop quickly, it may seem as though it appears overnight, or it can slowly develop.

Peyronie’s occurs predominantly in middle-aged men. However, it can occur in men of any age from their 20’s to those in their 70’s.

Peyronie’s disease is indicated by a build-up of plaques within the penis shaft. The plaques consist of scar tissue that does not stretch like normal tissue and painfully prevents the affected areas from expanding properly during erections. This can lead to the curve in the penis and deformities.

How do I know if I have Peyronie’s?

A plaque or nodule may be present.

Developing under the skin of the penis shaft the plaque presents as a thickened nodule or a lump. The development of excess scar tissue contributes to plaques forming anywhere along the penis shaft.

It is possible to feel the plaques under the skin, and they can change in texture. The plaques may feel soft at first, becoming firmer as they develop.

A shortened penis during erection.

The collection of scar tissue in the plaque may results in the penis changing shape, including curvature, indents, narrowing, shortening and hourglass. The curved penis is the most common indicator. This is most identifiable when the penis is erect. The penis will bend toward the side where the plaque is positioned. For men burdened with multiple plaques; more than one curve may occur. Understandably the larger the build up of plaque, the greater and more significant the curve.

Penile Pain

More than 50% of notice pain in their penis as an initial indicator of Peyronie’s. Pain can occur in both the flaccid and erect state. The pain does resolve within 12 – 18 months after it begins.

  • Erectile problems
    Peyronies can cause erection problems.
  • Erectile dysfunction
    Peyronie’s disease can cause erectile dysfunction (ED).
  • Congenital Penile Curvature also causes a bend in the penis during erection. This is an inherited condition. Peyronie’s is not.
    Congenital curvature will have existed the whole of the man’s life and may only be noticed during puberty. The curve will not progress; it remains the same over time. Peyronie’s develops in the man’s penis, and the signs and symptoms may change over time.

What causes the plaque to form?

There is no certain known cause. The theory exists that a one –off or repeated injury to blood vessels in the penis cause blood to leak into new areas that cause the body to react, sending an immune response that results in the scarring. Other theories refer to low levels of male hormones, a defect in genetics and even a rare congenital form that affects the man from birth.

How can it be diagnosed?

It is important to have Peyronie’s diagnosed by a physician to ensure it is not a congenital penile curve causing the curvature.

The presence of pain, palpable nodules and the curvature are usually indicator enough that it is Peyronie’s. The blood circulation of the penis may be assessed via ultrasound.

During diagnosis, the Doctor will be required to measure the curvature while erect. Your Doctor may accept pictures taken at home or will assess in the surgery.

Curing the curve.

Non-surgical treatment options have not proven to work for all patients. These include medication, injections, stretching and vacuum devices to gently stretch the shaft.

The only guaranteed treatment to have a beneficial effect on Peyronie’s disease is surgery.

Surgery can only be offered once the disease has passed the acute phase and the conditions have settled ( 12 – 18 months).

Extracorporeal shock wave therapy – vibrations from sound waves are used to break down the tough fibrous plaques. Shock waves are delivered by a device outside the body.

Nesbitt tuck procedure – removing some of the tissue from the side of the penis opposite the plaque. This straightens but shortens the penis.

Cutting out plaque – sometimes combined with the insertion of a plastic rod (prosthesis) to counteract any shortening.

Laser surgery – a carbon dioxide laser is used to thin the plaque.

Plication – folding the normal tissue on itself rather than removing it completely.

If you have a mild version of the disease which does not cause much pain, if you are not sexually active, or have few or no difficulties with sexual intercourse, you may decide that you do not want treatment. About 13% of patients recover from their symptoms without treatment

As with any surgery, there are risks involved. Shortening of the penis may occur, and there is the risk that the curve may return. You may be required to undergo a circumcision.

Recovery and resumption of normal ‘duties’.

The team at the Australian Centre for Cosmetic Surgery are skilled, experienced and discreet. They understand the sensitive nature of Peyronie’s Disease and are familiar with its symptoms and the emotional, physical and mental effects it can evoke. To address your painful curvature visit www.drcolinmoore .com or phone 0414251234 to book a consultation to determine how the Australian Centre for Cosmetic Surgery can help you.

Prof Colin Moore