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Peyronies disease treatment

Peyronie’s disease also referred as penile fibrosis causes a bend in the penis which makes an erection painful. Scar tissues also called fibrous plaques build up inside the thick and elastic membrane known as tunica albuginea which surrounds the corpora cavernosa and causes abnormal curvature resulting in pain, erectile dysfunction and shortening of the penis.

A small bent erection of the penis might be natural and cause no problems. In case of Peyronie’s disease, it might cause a significant bend or pain which cause in erectile dysfunction preventing you from having sex. This might lead to stress or anxiety in many men. Sometimes, it might get cured on its own over time but in most cases, it remains constant or worsen which requires treatment.

Symptoms

The symptoms of Peyronie’s disease may suddenly or gradually develop. Here are the signs you need to look out for:

  1. Feeling of the scar tissue – The formation of the scar tissues or plaques generally occur on the upper portion of the penis, but may also form on the bottom or side which can be felt under the skin of the penis as a strip of hard tissue or flat chunks.
  2. Erectile Dysfunction – Peyronie’s disease might cause complications to get or maintain erections. It also may lead to soft erections.
  3. Significantly bent or curved penis – Your penis might curve towards one side, bottom or up with or without erection.
  4. Pain – You may have penile pain during sexual intercourse or erection. Sometimes, you may feel pain in your penis even without erections.
  5. Shortening of the penis – You penis might become short or narrow due to Peyronie’s disease.

Causes

Though the actual cause of Peyronie’s disease is not completely understood, it is believed to result from repeated injury on penis or trauma. Injuries to the penis might happen during sexual intercourse, physical activity or any accident. However, many patients could not confirm any injury or traumatic event.

Diagnosis

An urologist usually starts to diagnose Peyronie’s disease by taking a medical and family history. During the physical examination, a urologist can feel the fibrous plaques in the penis with or without erection and can recommend to perform an ultrasound or X-ray of the penis to find the exact location of the formation of scar tissues.

Treatment

If the complications of Peyronie’s disease are not severe, a doctor may start the “watchful waiting” approach as studies show some cases where it improved without treatment. Many healthcare experts do not recommend surgery at the first instance and treat this disease for the first 12 months without surgery.

The aim of treatment is to eliminate pain and restore the correct physical structure of the penis for erection. An urologist may also suggest changing a man’s lifestyle to some extent in order to minimize the risk of erectile dysfunction by reducing alcohol consumption, quitting smoking, avoiding illegal drugs and exercising.

Nonsurgical Treatment

Medication and therapies that consist of nonsurgical treatment for Peyronie’s disease.

  1. Use of a penis extender – In medical terms, penis extenders are known as traction devices and many doctors agree that the most effective way to straighten a bent penis caused by Peyronie’s Disease is support the penis with traction devices. These devices are designed to fit the penis holding it straight for a certain period of time with a gentle pulling force which eventually straightens your penis over time with regular usage. As the name goes, penis extenders not only help to straighten the penis but also help to increase the overall length which most men are pleased to know.
    Penis extenders are classified as Type 1 medical devices which mean they have no side-effects on the users. The stretching causes tiny tears in the tissues of the penis which actually helps to produce new cells in these newly created spaces. These new cells are permanent and helps is restructuring of the penis. This therapy needs to be applied multiple times. The more the situation is bad due to Peyronie’s Disease the longer you need to use the traction device for the treatment.
  2. Medication – You doctor might prescribe some medications to treat Peyronie’s disease by reducing the amount of scar tissues. These include oral medications or medications to be injected directly to the plaques.

Oral Medications

  • Vitamin E – It is an antioxidant that makes the plaques smaller and helps to straighten the penis.
  • Potassium Amino-benzoate (Potaba) – This vitamin B-complex reduces plaque sizes but does not help to straighten your penis. It is costly and can upset your stomach which eventually makes men to stop its intake.
  • Colchinine – This anti-swelling medicine helps to make the plaques smaller but also cause stomach problems.

Penile Injections

  • Collagenase injections – It is injected directly into the plaques and showed improvements in curvature of the penis. It breaks down the buildup of collagen which produces the penile curvature
  • Interferon injections – It is a type of protein which controls swelling and when injected, it works by reducing the growth rate of the scar tissue and produces an enzyme which breaks the plaques.
  • Verapamil injections – This medication is primarily used to treat high blood pressure. This disrupts the production of collagen eventually reducing scar tissue and pain.

Other Treatments – These include the treatment of the penis with radiation, shock-waves, ultrasound and heat but are not proven yet and so not recommended by the experts. However, the study of these processes is being continued.

Surgical Treatment

Surgery is recommended only in severe cases and if the disease is not getting cured after 12 months. These are the recommended surgeries which a urologist will suggest:

  1. Grafting – In this method, the surgeon removes the scar tissue and attach a vein or skin from animal organs in its place. This allows the penis to straighten and restore lost length.
  2. Penile prosthesis – Penile prosthesis or penile implant is the oldest form of treating erectile dysfunction. A device is implanted to straighten the penis during erection and once implanted, a man must use the device to have an erection.
  3. Suturing (plicating) – In this method, the penis is straightened by removing a small portion of the tunica albuginea from the side of the penis opposite the plaque. This process results in shortening of the penis.

It is very important to consult a doctor as soon as possible if there are any symptoms of Peyronie’s disease because the treatment takes a lot of time and might worsen over time as well.

Lavern T. Smith

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