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Peyronie’s Disease

Alejandro Miranda-Sousa, M.D.

Peyronie’s Disease What is Peyronie’s Disease?
Peyronie’s Disease is a condition in which plaque formation occurs inside the penis. The plaque build up leads to a reduction in the elasticity of the tissues and the flexibility of the penis during erection, leading to curvature.

Prevalence and Impact:
Peyronie’s Disease is estimated to affect up to 9% of men each year. It is more likely to occur in men over the age of fifty. However, the of occurrence of Peyronie’s Disease may actually be higher due to men’s embarrassment about the condition and limiting reporting of disease. Therefore, this condition can cause a great deal of stress to patients, so detailed history and physical examinations are important.

Causes:
The cause of Peyronie’s disease is not completely understood, however, it appears to be most commonly due to trauma or injury. Additionally, men who have a connective tissue disorder such as Dupuytren’s Contracture, appear to have an increased risk of developing Peyronie’s Disease. There is inconsistent evidence between the association of Peyronie’s Disease and diabetes, high blood pressure, and high cholesterol.

Signs and Symptoms:
. Penile Pain with or without an erection
. Abnormal penile curvature
. Difficulty attaining or maintaining an erection
. Difficulty or complete inability to penetrate penis
. Palpable fibrosis plaque
. Indentation in the shaft of the penis

Peyronie’s Disease can be divided into two phases. The acute phase usually last for the first 18-24 months. During this phase, penile pain can occur and some bending/curvature of the penis. The chronic phase is often characterized by stable plaque formation, and penile angulation. Erectile dysfunction is often related to the chronic phase.

Peyronie’s Disease is often diagnosed on physical examination. No imaging study is mandatory for the diagnosis of Peyronie’s Disease, however, under certain circumstances; additional imaging through ultrasound may be beneficial to locate plaque that not easily palpated on physical examination.

Treatment
Spontaneous resolution of Peyronie’s Disease is unlikely to occur. This condition can remain stable or worsen over time. Treatment is based on how bothered the patient is by penile pain and the impact it has on patients sexual relations. The optimal treatment for Peyronie’s Disease has not yet been identified, however; there are a number of different options. Oral medications, injections, and surgical options are available depending on the severity of the disease course. The success of the treatment is measured by the degree of improvement in the penile curvature and plaque, and the return of sexual functioning.

It is always recommended to consult an experienced urologist to determine the best next step in the treatment of Peyronie’s Disease.

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