The male penis serves a very important role in urinary function and as a sexual organ. The penis is a cylindrical organ which consists of 3 separate parts. In the upper portion there are 2 cylindrical bodies which lie side by side (corpora cavernosa) and are surrounded by a layer of connective tissue called the tunica albuginea. The 3rd chamber is a column of connective tissue which covers the urethra (a narrow tube which carries urine and semen outside the body). Peyronie’s disease is a condition in which plaque or scar tissue is formed within the tunica albuginea of the penis. This may cause problems such as a curved and painful erection.
Peyronie’s disease may be caused due to penile trauma (hitting or bending) which causes internal bleeding in the penis. Trauma may be caused due to vigorous sexual activity or injuries from sports or accidents. Defects in your genetic make-up such as low testosterone levels may also cause this condition.
The initial symptoms of Peyronie’s disease are painful erection and thickening of the penis. You may also notice a curvature or bend in the penis which is most obvious when the penis is erect. There can also be symptoms like lumps in the penis, soft erection and difficulty in penile penetration. In very severe cases the plaque may accumulate calcium and become very hard.
A physical examination of the penis is sufficient to diagnose Peyronie’s disease. Your doctor may have to induce erection using injection to measure the bend or distortion when the penis is erect. In some cases photographs or X-ray examination of the plaque may be required to check for the presence of calcification.
There are various types of treatments for Peyronie’s disease. You may also decide not to have the condition treated if the condition is very mild and if you have few or no difficulties during sexual activity.
Non-surgical treatments include:
Stretching: This process involves wearing a device which stretches the penis to help reduce the deformity or bend.
Vacuum devices: These devices create a vacuum around the penis which stretches the shaft of the penis.
Oral or topical medications: Oral or topical medications can be prescribed for reducing the curvature and thickening of the tissue. These medications should be used for nine months for the best results.
Injected medications: Medications are injected into the plaque areas to reduce pain and the curvature of the penis.
Your doctor will suggest a surgical treatment only if the condition has attained stability and you have been pain free for at least 6 months.
Some of the surgical treatments are:
Nesbitt tuck procedure: Some amount of tissue from the side opposite to the plaque is removed. This straightens but shortens the penis.
Plication: This involves folding the normal tissue on itself rather than to remove it.
Plaque excision and grafting: The plaque is separated from the underlying erectile tissue and removed. The defect is then filled with a graft.
Surgical treatment gives a guaranteed cure for Peyronie’s disease. However, it involves risks such as shortening of the penis or chances that the distortion might return. There are also chances that you may feel the knots or stitches below the skin. All these issues must be considered prior to consenting to surgery.