Peyronie’s disease is one of those medical conditions that cause some men to lose sleep. It has the potential to cause strain in the romantic relationship between a man and his partner. Worse still, it is capable of making you a butt of jokes among ladies. Men who have this problem may be reluctant about discussing it with anybody, including a doctor. As a result, they continue suffering in silence. You may be wondering what causes this problem and, most importantly, what you can do about it. You are in the right place because we discuss these and other relevant issues in this article.
What is Peyronie’s disease?
Peyronie’s disease is a problem that affects the penis. It is a form of erectile dysfunction, according to some experts. The condition causes deformation of the male organ such that it curves abnormally, especially when erect. This may cause men who are affected to experience pain whenever having sexual intercourse. The disorder results from growth of plaques in the soft tissues present in the penis. Its extent usually differs between men, ranging from mild to very severe. In some cases, the angulation of a penis affected by this issue could range up to 45 degrees.
The connective tissue disorder took its name from Francois Gigot de la Peyronie, a famous French doctor. In 1743, the personal physician of King Louis XV described the condition as being caused by observed “rosary beads of scar tissue.” But people had known about and described the disorder before then. Peyronie’s popularity and connection to notable people, including Peter the Great, probably contributed to his name being associated to it.
Besides being called Peyronie’s disease, this condition is known by many other names. These include penile curvature, fibrous sclerosis of the penis, curved penis, chronic inflammation of the tunica albuginea, Van Buren’s disease, and induratio penis plastica.
Who does it affect?
Peyronie’s disease is considered more of a problem among middle-aged men. Statistics show that those between the age of 45 and 60 years, an average of about 53 years, are most affected. Estimates indicate that up to about 5 percent of men have it across the globe. It has also been observed that it is mostly common among Caucasian men, especially of northern European or Scandinavian ancestry. It is less common to rare or unknown among men of African or Asian descent.
While this disorder mostly affects the middle-aged, it can also affect men who are much younger. Up to about 10 percent of those having it are younger than 40 years, according to Healthline. The lower threshold of age range of those said to be affected is 18 years. Although common among older men, WebMD says it is not as a result of aging.
What causes the disorder?
Unfortunately, it is not clear what causes Peyronie’s disease to develop. Researchers have not been able to pin down the exact causes. But what appears to be a general consensus is that it develops as a result of trauma or injury. This could be from forceful hitting or bending of the organ. The trauma may be from sexual activity or certain athletic activities, according to Mayo Clinic. It may well be the outcome of an accident.
Penile curvature is actually the effect of the body trying to heal an injured part. Following a trauma or injury to the penis, there is first an inflammatory reaction. There will also be pain sensation, especially when having an erection. Many men may try to weather this and, of course, the problem may appear to go away after a while. But the inflammation and bleeding soon lead to formation of scar tissue or benign fibrous plaques.
In most cases, only a scar is present. But there could also be multiple scars lining the shaft, mainly on the upper or lower part. These scars can stand in the way of complete extension of the penis when erect. The extent of curvature to be seen will be determined by the size, number and location of the scars. Distortions may advance to a degree where an affected penis is described by such terms as “corkscrew” or “J” when erect.
Men who have Peyronie’s disease often aren’t able to remember if they experienced a trauma that could have led to it. The condition has been observed in some cases to have developed slowly without any apparent cause. The National Kidney and Urologic Diseases Clearinghouse (NKUDC) says it could occur in the absence of trauma.
Experts note that your genes may predispose you to having Peyronie’s disease. Men who have Dupuytren’s contracture, another connective tissue disorder, are also more likely to have this one as well.
How is it diagnosed?
Urologists are the medical professionals that are usually approached in dealing with this sort of issue. Such a person has received training in how to diagnose and recommend treatment for Peyronie’s disease and other issues affecting the penis. You can also consult your regular doctor, but you will likely still be referred to a urologist for proper attention.
Physical examination will be carried out to assess the scar tissue in your penis. An erection may need to be induced for proper evaluation to be done. The medical professional may also have you undergo an X-ray or ultrasound to rule out other possible causes. A biopsy is also done in rare instances.
What options do you have for treating the disorder?
Before deciding on a course of treatment, your doctor may advice that you wait for some time. This waiting period could range from few months to two years, possibly longer. The reason for this is that mild cases of the disorder can resolve without any intervention. WebMD says it may not be necessary to seek treatment if the problem does not impact your sex life adversely.
Treatment is necessary if your Peyronie’s disease is severe or comes with painful erection that persists. But it has to be said that this is not the easiest of conditions to deal with. In urology, it is regarded among the most difficult to combat. The degree or nature of the problem differs among men. As a result, there is practically no one-size-fits-all in fighting it. Little wonder the disorder is described as “the doctor’s nightmare.” Some qualified doctors entirely avoid working in this field because of the frustrations that come with it.
Of course, there is a variety of treatment available. The problem is that there is no “gold standard” for combating Peyronie’s disease. Healthline notes that there is no cure for it. However, below are the common options you have for treating the condition.
Your doctor may recommend some drugs to combat the disorder. These are usually taken via the oral route or injections. However, the results these medication produce are mixed. Their efficacy has not been well studied. Following are some popular drugs that may be suggested.
Potassium amino-benzoate (Potaba)
This medication is among the newer options you have for the treatment of Peyronie’s disease. Potaba, and similar agents such as pentoxifylline, targets the mechanism of inflammation. These agents are the ones your doctor will likely recommend at the beginning of treatment. They are ideally used in the early stage of the development of the disorder. The vitamin B-complex reduces size of plaques or scars in the penis. But it does nothing about the curvature. Its cost is rather prohibitive and it can cause upset stomach.
Another drug used at early stage of Peyronie’s disease development, tamoxifen is also taken orally. The non-steroidal medication is typically used for the treatment of desmoid tumors. Its mechanism of action makes it beneficial for dealing with plaques in the penis. But like Potaba, the anti-estrogen treatment does not improve the curve of the penis.
Collagenase clostridium histolyticum
This is one of the latest treatments that are available for this male connective tissue disorder. The United States Food and Drug Administration approved it as the drug Xiaflex in 2013 for combating Peyronie’s disease. Collagenase clostridium histolyticum was previously used only for treatment of Dupuytren’s contracture, which is a risk factor for the condition.
The injectable drug functions by breaking down collagen buildup in the penis. The FDA approves its use for men with curvature greater than 30 degrees during erection. Collagenase is also a pricey option for treating this condition.
Your doctor may suggest verapamil if agents such as Potaba and pentoxifylline didn’t work. This drug, which comes in oral and injectable forms, is primarily for management of high blood pressure. Studies suggest it is beneficial for dealing with pain and curvature of the penis. An appealing thing about the use of verapamil is that its cost is friendlier on the pocket.
Researchers have observed that this drug can impact on collagen buildup in the penis. It inhibits the proliferation of fibroblasts. Interferon, usually given as injections, breaks down fibrous tissue in the male organ. But like several other drugs, it is less effective when plaque calcification has occurred.
This is the traditional treatment for Peyronie’s disease. But surgical procedures are considered an option of last resort these days. They are for men with severe cases, such as when the disorder impedes ability to have sex. Doctors typically recommend that surgery only be considered when plaque and curvature are no longer getting worse. The men for the procedure should have also been without pain sensation for a minimum of about nine months.
There are different procedures that can be carried out, depending on goal. The common solutions when surgery is concerned are:
- Lengthening the side of the penis with scar tissue
- Reducing the length of the side not affected by scar tissue (e.g. Nesbit procedure or plication)
- Inserting penile prostheses or implants
Possible complications are a major reason why surgery needs only be considered when all other options have failed. For example, penile lengthening procedure may lead to erection problems. Your penis may become much shorter in the case of shortening surgery. In some cases, complications cannot be reversed. For these reasons, doctors are usually very careful about suggesting surgery.
Vacuum and penile traction devices like Proextender are among the options you have for dealing with Peyronie’s disease. Urologists typically use them in combination with medications. They can improve curvature, pain and erectile function. Penile traction therapy, in particular, has been shown in research to be potentially beneficial to men with this disorder. You need to put on the devices for between 4 and 8 hours daily. In order to guard against nerve damage, you will have to release them every 20 minutes.
Modification of lifestyle choices
Successful treatment of penile curvature will depend on your lifestyle choices. You will need to address risk factors that usually predispose men to erectile dysfunction. These include tobacco smoking, use of recreational drugs, and alcohol intake. It will also be beneficial to avoid sedentary lifestyle as much as possible. Engage in regular physical exercise. These changes will help to keep the disorder under control.
This is not really a direct treatment for Peyronie’s disease per se. Counseling can help to deal with issue that may result from the disorder. Men affected by this condition may withdraw from their partners due to effects on their sexual performance. Some could even suffer depression. Counseling by an expert will therefore be useful.
For many years, researchers have looked into the use of vitamin E for correcting curved penis. The supplement showed potential, especially in older studies. In one of the more recent studies published in 2013, daily supplementation with the vitamin (600 mg) helped to reduce curvature in subjects. Its combination with colchicine has been shown to inhibit aggravation of the disorder.
Coenzyme Q10 is one of the newer agents showing potential for helping men with Peyronie’s disease. The use of its supplements led to reduction in penile curvature among early-phase patients in a 2010 study that appeared in International Journal of Impotence Research.
There are other natural remedies that are thought beneficial for treatment of this condition. However, most of them lack convincing research evidence backing their efficacy.
Where to look for help
It is advisable to seek medical attention as soon as you suspect having Peyronie’s disease. But many men are at a loss as to the best places to go for help. It is not uncommon to see some asking online about the best clinics or doctors.
Urologists are usually the experts that help men with this disorder. However, not every one of these professionals may be willing to help. Some will likely want to avoid the disappointments and confusion often experienced in trying to deal with it. Your doctor may be able to provide useful recommendations on best doctors or clinics. You can also use the “Physician Finder” tool on the website of the Association of Peyronie’s Disease Advocate (APDA) to find an expert in your area.
Mayo Clinic is a notable name among the best clinics that work in this field. It has several urologists who specialize in the treatment of Peyronie’s disease. The clinic says it helps around 500 men with this condition every year.
Aside Mayo, Cleveland Clinic, The Men’s Clinic at UCLA, and Saudi German Hospital Dubai also look like great places to look for help.
In terms of specialists, we can say the choice of the best is somewhat subjective. Dr. Laurence A. Levine, a professor of urology at Chicago’s Rush University Medical Center, is ranked among the best in this field. Other notable experts include Dr. Joel Gelman, Dr. Wayne Hellstrom, Dr. Irwin Goldstein, Dr. Fred Grossman and Dr. Giannis Paulis. These are some of the best specialists in the world when it comes to Peyronie’s disease.
Seeking timely intervention
We need to emphasize the importance of seeking medical assistance as soon as you suspect having this disorder. The emphasis here is necessary because of how tentative many men tend to be about seeking professional help. The effectiveness of treatment will depend on how long you have had it. This then means that you are likely going to have it tough when you leave the condition unaddressed for too long.
It is also important to quickly see a doctor because other disorders may be responsible for observed signs. For example, the extremely rare sarcoma of the penis (a form of cancer) is a possibility. This shares certain symptoms with Peyronie’s disease.
Researchers continue to work to have a better understanding of this condition for development of more efficacious treatment. In addition to the treatments mentioned here, others such as penile stretching exercises and shockwave therapy are said to help. But their efficiency has not been adequately proven in research. While there is so much information out there on Peyronie’s disease, you should not substitute that for the services of a specialist. You should have your penis checked by one if you suspect a problem. Such a professional can also provide appropriate guidance, including on insurance coverage, if you need treatment.