What is Peyronie's Disease?

Although a clear cause has not been described, most researchers believe that the disease is caused by repeated injury to the penis due to trauma or aggressive sex. However, most commonly, no specific trauma to the penis is recalled. After the penis has a microscopic (not visible to the eye) injury, the body will send cells to “repair” the injury. On certain occasions, those cells cause inflammation and fibrous scar instead of healthy elastic tissue.

The penis contains two sponge-like tubes called the corpus cavernosum. These are the tubes that fill-up with blood and give rise to an erection. Each corpora cavernosum is surrounded by a sheath or covering of elastic tissue called the tunica albuginea.

In Peyronie’s disease, the tunica albuginea forms scar tissue that does not stretch, and when the corpora fills up with blood during an erection, the penis bends or becomes disfigured.

Research shows a prevalence close to 8%. That is, 1 in every 11 men suffer from the condition. Men with diabetes, history of trauma to the penis, low testosterone, and those with history of radical prostatectomy for prostate cancer are at risk of developing Peyronie’s disease.

Symptoms of Peyronie’s disease include:

• Bend or curve in the penis
• Hardness or lump in the penis.
• Narrowing or shortening in the shaft of the penis.
• Painful erection, or pain during sexual intercourse.
• Erectile dysfunction

Peyronie’s disease is diagnosed with a thorough history and physical exam. Dr. DeLay will ask you specific questions about your medical history, sexual history and timing of your symptoms. Then a physical exam is performed in order to identify any presence of scar tissue in the penis. The penis is palpated when the penis is not erect, to identify the location and amount of scar tissue.

Dr. DeLay will often perform a penile doppler to help chara cterize the plaque inside the penis. Depending on your erectile function, the penis is injected to cause an erection and better identify the characteristics of your curvature.

Non-Surgical Treatment of Peyronie’s Disease

Oral Medications:

A number of oral medications have been tried to treat Peyronie’s disease. However, research has shown that these are not effective.

Inject-able Medications:

• The only FDA-approved medication for Peyronie’s disease is collagenase clostridium histolyticum (called by its brand-name, Xiaflex). It is approved to treat penile curvature and a palpable plaque. Other injectable medications used are Verapamil and Interferon.
• Injection therapy should be combined with penile modeling and/or traction therapy.
• Patients with good erectile function and a palpable plaque that is not on the ventral aspect (bottom side of the penis) are candidates for injectable therapy.

Traction Therapy:

• Penile traction therapy (penile modeling) involves the patient to perform stretching exercises of the penis. Penile traction therapy has been shown to help preserve length post-operatively following surgery. These techniques are used in combination with inject-able medications.
• Dr. recommends the use of a Vacuum Erection Device and the RestoreX Device as part of traction therapy.

Surgical Treatment of Peyronie’s Disease

Surgery is considered the standard of care for Peyronie’s Disease. If the deformity of your penis is severe or sufficiently bothersome, your doctor might suggest surgery to correct it. Surgery is usually recommended when your curvature has remained stable (without change) for at least 3 to 6 months. There are different types of surgeries that can be offered depending on:

• Degree of curvature
• Degree of bother: how bothered you are by the deformity
• Erectile function
• Penile length: Subjective (patient reported) and Objective (observed on physical exam by your doctor).