Peyronie's Disease
What is it?
Peyronie's disease is when scar tissue, or a hard lump, forms inside the penis. Although the cause is not really known, it has been suggested that trauma (such as hitting or bending) of the penis can trigger the development of scar tissue.
In its mild form, Peyronie's disease can improve without treatment in 6 to 15 months. In most cases, the hardened scar tissue can make the penis less flexible, cause pain and force the penis to bend or arc during erection. In severe cases, this pain, bending and associated emotional distress can cause impotence and make sexual intercourse difficult or even impossible.
Peyronie's disease occurs in about 1% of men, and is most common in middle-age, although it can also affect young and elderly men. Some men with the disease develop scar tissue and hardened cells in other elastic tissues of the body, such as the hand or the foot.
What are the symptoms?
The symptoms of Peyronie's Disease can be mild or severe, and can develop suddenly or gradually. Symptoms include:
How is it diagnosed?
The doctor will take a full medical history from you, and examine your penis for hardened tissue, which can often be felt. Sometimes, it is necessary to perform the examination with your penis erect. To do this, a substance that relaxes the blood vessels is injected into the penis, causing erection. If you are able to take photographs (digital or Polaroid) of the deformity in your own home, this may help your doctor when you visit your surgery.
An x-ray or ultrasound scan (soundwaves used to get an image of the inside of your penis) can sometimes show up hardened plaque.
What is the treatment?
Surgery is the only effective treatment, although in some cases it does lead to shortening of the penis or some loss of erectile function. Because the scar tissue in Peyronie's disease sometimes shrinks or disappears without treatment, it is often suggested that you wait one year or longer before trying surgery to correct it. During this waiting time there are a few options that might improve symptoms, although these are of limited effectiveness.
Vitamin E and B-Complex tablets may be suggested, and chemical agents injected directly into the scar tissue may help to break it down. Shock Wave therapy (high-energy rays directed to the scar tissue to break it down) has been used. However, like the chemical treatment, it seems to reduce pain, but not have any effect on the scar tissue itself. The body's own healing mechanism is the best non-surgical treatment for Peyronie's disease.
Surgery
There are two types of surgery that are most commonly used to treat Peyronie's disease. The first is surgical removal of the hardened tissue, which usually involves a graft onto the penis. This method may mean that erectile function is partially lost, and the penis is not as rigid as before. The second type of surgery is the removal or 'pinching' of tissue from the side of the penis opposite the scar tissue. This cancels out the bending effect, although it does mean the erect penis is shorter.
Some men choose to have an implanted device that increases rigidity and may straighten it out. In other cases, cuts, pinches and grafts will have to be performed alongside the implant, if the implant alone does not straighten the penis.
Further information
Your local GP surgery is the best place for you to find information on Peyronie's disease, especially if you have specific concerns about your symptoms or treatment. Charities can also be useful sources of information and support.
Men's Health Forum www.malehealth.co.uk
