Peyronie’s disease is a scarring condition beneath the skin of the penis that leads to a curved erection, and can make sexual intercourse difficult and painful
It can also manifest with a lump or indentation in the penis, difficulty getting an erection (ED), penile shortening or deformity. Its cause is unclear, but it might be related to minor trauma.
First described by Francois de la Peyronie in 1743, Peyronie’s disease affects up to 10% of men during their lifetime, and is often linked to ‘vascular’ risk factors such as diabetes, high blood pressure and high cholesterol. It is also more common in men with a low testosterone, or those with a history of pelvic surgery including radical prostatectomy for prostate cancer.
A small proportion of patients may improve spontaneously, but the majority either remain stable or progress to a more severe deformity.
Unfortunately no treatment can get rid of the scar tissue, and treatment is aimed at alleviating symptoms, correcting the deformity and restoring sexual function.
Treatment Options: (all available at Wessex Andrology)
Tablet Therapy:
No tablet treatment has been shown to reverse penile curvature, but some medications can be of use in Peyronie’s disease.
Vitamin E or Pentoxyifylline can improve the inflammatory pain during the acute (inflammatory) phase, which is sually in the first 6 months.
The use of Potaba® (Para-amino-benzoate) has been to shown to limit worsening of the curvature, but requires 4 times a day treatment, and it can cause gastro-intestinal side-effects.
Mechanical Therapy:
There is emerging evidence for the benefit of vacuum therapy device exercises, and this involves a daily stretching exercise for 5-10 minutes for 3-4 months. A trial is currently underway to study this in more detail, but initial data suggests that half of men achieve a sustained improvement in penile curvature.
Surgery:
A significant proportion of men with Peyronie’s disease require surgery to correct their deformity and restore sexual function. Mr Rees performs over 50 procedures a year for Peyronie’s disease.
There are 3 broad types of operations for Peyronie’s disease:
Nesbit (or Yachia / Lemberger / Essed plication) – these procedures are aimed at shortening the long (healthy) side of the penis – they are simple, have a low complication rate and high success rate (less than 5% require further treatment).
Incision and Grafting (Lue) procedure: this is a procedure is aimed at cutting into the scar tissue to create a gap, and inserting a graft (such as a piece of vein, or bovine collagen) into that gap. It has the potential advantage of causing less penile shortening, but due to the complexity carries a 30% complication rate in the medium term – such as erectile dysfunction recurrent scar tissue etc.
Penile prostheses: Where there is a combination of penile curvature and erectile dysfunction, often the best and most durable solution is to insert a penile prosthesis or implant.
30 Urologists, patients and others cycled from London to Orleans in France in aid of the urological charity TUF. In his first charity bike-ride, Rowland joined the cyclists for the 130 Km first leg of… Read more
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