Peyronie’s disease, or curvature of the penis, refers to when the penis bends abnormally when erect. The condition may result in the inability to have sexual intercourse because of pain or erectile dysfunction.
The penis contains three sponge-like tubes: a hollow tube called the urethra and a pair called the corpus cavernosa. The role of the penis is to ejaculate sperm and carry urine out of the body through the urethra.
The corpus cavernosa is the erectile tissue of the penis. These tubes are full of blood vessels that become full of blood when a male is sexually aroused, resulting in an erection. Calcium in the cells
Peyronie’s disease occurs when fibrous scar tissue develops under the penis’ skin, which causes the penis to curve abnormally when erect.
According to the National Institute of Health, every
However, It is difficult to accurately determine the true prevalence of the disease because of the embarrassment that prevents many people with this condition from seeking out healthcare.
This means the condition is likely underdiagnosed and under-treated. Doctors estimate that in reality, at least 4 out of every 100 males between the ages of 40-70 have Peyronie’s disease.
A note about sex and gender
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It most likely results from damage to small blood vessels, which can occur from vigorous sex, trauma from sports, a surgical procedure, or another type of accident. During the healing process, cells can become trapped where the injury had occurred, resulting in scar tissue.
The corpus cavernosa sits in an elastic tissue casing called the tunica albuginea. This casing becomes stretched when the penis is erect. If a person injures their penis, the tissue of this elastic casing can become damaged. Proper healing will result in no noticeable consequences.
However, if there is permanent scar tissue, there is a chance a person may develop Peyronie’s disease. Because that part of the casing can no longer stretch properly when the penis becomes erect, the scarred part that cannot stretch pulls at the penis, bending it.
However, not every male who experiences a penis injury will develop Peyronie’s disease. Certain risk factors can predispose some people to develop it more than others.
Risk factors of developing Peyronie’s disease
Individuals with close relatives with Peyronie’s disease are more likely to develop it themselves, with suggests that it may be genetic in some cases.
A connective tissue disorder called Dupuytren’s contracture is also
Because some cases of Peyronie’s disease occur without injury, it is possible that an auto-immune system disorder causes it in some cases.
Signs and symptoms of Peyronie’s disease may either emerge gradually or abruptly.
Peyronie’s disease has two stages:
The acute phase lasts
A person can feel the scar tissue under the skin of the penis. It feels like a band of hard tissue. For some, it may feel like flattened lumps. Often, a person may experience sudden or new erectile dysfunction (ED), which is when males may have difficulties getting or maintaining an erection.
The penis may bend sideways, downward, or upward, depending on where the plaques are located. Sometimes, the erect penis may become very narrow at a certain point. In some individuals, the bend slowly becomes more pronounced.
For others, it gradually improves. For others still, the curve stays the same. Peyronie’s disease can eventually result in a shortening of the penis.
At the chronic stage, the scar tissue is no longer growing. The symptoms may also include ED.
Usually, people do not experience much pain at the chronic stage.
A urologist, who is a doctor specializing in sexual and urinary problems, will ask a person questions about their medical history, symptoms, and whether or not they developed over time (sudden or gradual). Their doctor will also perform a physical examination.
A doctor can feel plaques in the penis when it is not erect. If they need a person to have an erection to determine if there is scar tissue, they may need to stimulate an erection with medications or ask a person to take photos in the privacy of their own home.
The doctor may also choose to perform a dynamic ultrasound. This type of ultrasound uses sound waves to show where the plaque is located, look for calcium buildup, and examine the flow of blood inside the penis.
If the patient’s curvature is not getting worse, there is only minimal pain, and the symptoms do not interfere with sex or urination, the doctor will probably recommend a wait-and-see approach.
A doctor will typically want to observe any changes for at least 12 months before considering surgical intervention.
Conservative therapy is the most common recommendation during the active phase, with doctors choosing more invasive treatments for the chronic phase.
Not all males with Peyronie’s disease require treatment. The end goal is to reduce pain and restore a man’s ability to have sexual intercourse. Treatment is usually reasonably conservative.
There is no cure for Peyronie’s disease. Still, specific lifestyle changes can help reduce the severity of symptoms. These include:
- limiting alcohol intake
- quitting smoking
- avoiding illegal drugs
- exercising frequently
Some individuals with Peyronie’s disease have found relief with the following:
Shock wave therapy. This therapy breaks up scar tissue.
- Penile traction therapy or vacuum devices. These can help stretch the penis.
- Penile injections. Some doctors may choose to do an injection with interferon to help break down fibrous tissue and reduce its production. However, the Food and Drug Administration (FDA) has only approved one injection drug to treat Peyronie’s disease, collagenase clostridium hystolyticum (Xiaflex). Doctors use this penile injection for individuals whose penis bends at an angle of
30 degrees or morewhen erect. It is an enzyme that reduces the size of plaques and sometimes gets rid of them altogether.
If the curvature is severe and prevents the patient from having sex, the urologist
- Shortening one side of the penis. It is possible to shorten the unaffected side of the penis, which is the side without plaques. This stops the bending during an erection. This procedure shortens the length of the penis. Because of this doctors will usually consider this procedure if the curvature is not too severe (less shortening required) and the man’s penis is long enough.
- Lengthening one side of the penis. The surgeon cuts the scar tissue is cut in, allowing the sheath to stretch again. If the sheath extends adequately, the male’s erect penis will be straight. During the procedure, the surgeon may remove some scar tissue and graft over the parts taken out. This procedure is usually best for patients with a shorter penis or more severe curvature. However, lengthening the side has a higher risk of causing impotence than shortening.
- Implant. A doctor can surgically insert implants into the spongy tissue that becomes engorged with blood during sexual arousal and produces an erection. There are two types of implants: permanent ones and those that inflate with a pump action in the scrotum. The permanent implants will erect the male semi-rigid penis, which is enough for sexual intercourse. At the same time, the pump-activated one will provide a better erection. The surgeon can remove some of the scar tissue to reduce curvature.
- Vitamin E and potassium aminobenzoate. These medications might reduce pain but typically have no significant impact on pre-existing abnormal curvature.
- PDE5 inhibitors. Doctors often prescribe ED medications such as tadalafil (Cialis, Adcirca). While these medications are intended to treat ED, they may also help relieve Peyronie’s disease symptoms, especially in the acute phase.
The main complication of Peyronie’s disease is the inability to have sexual intercourse because of pain, ED, or both.
Anyone with a curvature of the penis that is causing them discomfort or distress should speak with a doctor. Treatment options are available.
There is no prevention of Peyronie’s disease, as the condition often occurs due to the way a person’s body manages injury and inflammation.
Any change in the function, sensation, or appearance of the penis may indicate an underlying medical condition, and a person should see their doctor.
It is typical for a male’s penis to curve slightly. However, if the curve causes pain, urinary dysfunction, sexual dysfunction, or if the bend is severe, then it is a problem.
Peyronie’s disease can undermine a male’s ability to have sex by causing ED. A person should see their doctor for proper evaluation and treatment.
The following are answers to some additional questions about Peyronie’s disease.
Is Peyronie’s disease an STD?
Peyronie’s disease is not a sexually transmitted infection (STI) and cannot pass from person to person.
Can Peyronie’s disease go away on its own?
It is very uncommon for Peyronie’s disease to go away on its own. The condition may worsen over time, so early diagnosis and treatment are ideal.
What can be mistaken for Peyronie’s disease?
Sometimes a doctor may diagnose what is known as corporal fibrosis. This is the scarring that sets in within the erectile tissue. The causes can be Peyronie’s disease or conditions
Sometimes a doctor may think that this scarring and related ED results from a cause other than Peyronie’s, in which case they may misdiagnose a person.
In extremely rare cases, a person could also develop epithelioid sarcoma of the penis, which is a cancer of the penis that can be mistaken for Peyronie’s disease. This sarcoma is a very treatable condition.
When does a curved penis become an emergency?
A penis fracture is a rare but severe injury that requires surgical intervention. It happens when an erect penis is bent forcefully and is an emergency.