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Peyronie's disease and abnormally bent penis
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causes, symptoms and treatment options
Peyronie's disease is a connective tissue disorder of the penis that leads to bending and disfiguration of the penis and to hard thickened inelastic areas in the penis.
Peyronie's disease consists of fibrous tissue, called plaques, developing within the penile shaft. The plaques are hard, thickened and stiff areas with exagerated growth of connective tissue, actully a kind of internal scarring.
The Peyronie's ailment is also called cavernositis, and also sometimes plastic induration. There is probably a chronic inflammation process that leads to this scarring.
Scarring is fibre rich conective tissue that can grow on places in the human body. Usually this happen to repair damage. Chronic inflammation in areas in the body often lead to damages that causes exagerated growth of scar tissue.
The thickened area has less blood flow than normal penile tissue, and do not fill with blood and swell as the normal spongy areas in the inside of the penis. Therefore the penis swells more at the opposite side, and gets a curvature towards the side containing the plaques when erected.
If the plaques are situated at both sides, more complex deformations will develop. The abnormal bending, twisting or swelling within the penis, often also lead to painful erections.
Scar tissue formed to repair damage or caused by inflammation tend to be replaced by normal functioning tissue after some time. This can happen also by Peyronie's disease. Therefore the condition can sometimes improve or heal by itself.
The diseases is named after the French surgeon, François de la Peyronie, that first described the disease in 1743.
The three main characteristics of cavernositis are:
One or more small hard lumps underneath the skin, or a continous hard, stiff and thickened area.
Abnormal bent or crooked penis when erect. All penises have some curvature, but by this disease, the penile bend increases, and one may get a very curved penis. The penis may be bent as a banana or in an angular fasion. The penile bending are most often up, but may be down, to the left side, to right, sloping or down.
The benings are usually to the same side of the hard thickened area when the penis is erected.
The hard areas in the erected penis may look like bumps, making the penis irregular.
Sometimes the penis bends greatly enough to make sexual intercourse difficult, or impossible.
The plastic induration may progress and cause erctile dysfunction or impotence.
Pain during erections caused by the pressure from the hard areas in the penis, or from the streched skin at the opposite side of the penis.
One may not notice the bend immediately, as it tends to develop over one to three months and later than the hardness and stiffness of the indurations.
Sometimes the Peyroni's disease will clear up by itself, but this may take several years.
Plastic induration of the penis is not cancer or an infection, and cannot cause cancer or infections, however a lomp or deformation in your genitals that developes, must be examined.
The disease sometimes makes it difficult or impossible to perform intercourse or other sexual activities, or the joy of sexual activities is dimmished or gone. This may lead to emotional distress and problems in the relationship with the partner.
How common is Peyronie's disease?
Any man from the age of 18 and upwards can develope Peyronie's disease. The average age of men suffering from Peyronie`s disease is 50. The disease is most often seen in caucasian males. Ca 1 % of all men have this disease to some degree.
Men having Peyronie's disease also often have connective tissue disease in their hands and feet, for example a condition called Dupuytren's contracture, which is a cord-like thickening across the palm causing fingers to pull inward.
There may be an auto-immune reaction towards the erctile tissue contributing to the disease.
Repeted injuries to the penis may cause the disease or contribute to its cause. A habit of forcefull sexual activity may cause such repetitive injuries.
The initial causes create an inflammation and this inflammation induce growth of fibrous connective tissue that form the plaques.
The erectile bodies corpora cavernosa laying at the side of each other at the upper part of the penis have a sheet of connective tissue. Between the bodies, these sheets form a common tissue layer.
The connection between this common sheet and the indiviuals heets of both erectile bodies is especially voulnerable to mechanical forces, and at these points ruptures easily take place that proceed into the erectile tissues of the bodies.
Such ruptures seem to induce proliferation of fibrous tissue tha grow into the erctile tissue and form the plaques.
Not all men with Payronie's plastic induration require treatment. If the condition is pronounced, it is also difficult to find a remedy that can cure every sign of the disease, but several methods can take away most penis changes associated with Peyronie's. Here is a survay of treatment methods used tody.
Tamoxifen:
In its early stages of the disease a medication called Tamoxifen has been shown to prevent the formation of the fibrous plaque by peyronie's disease. This preparate is also used in the treatment of breast cancer, but the two conditions are not related.
Intralesional injections:
Sometimes the doctor injects substances that can break down connective tissue
fibres into the thickened areas, such as the enzyme collagenase or calcium
channel blockers. This softens the area and may allow normal tissue to replace
the scarring. One gives several injections in a three month's time. Injections
of anti-inflammatory drugs, like steroids has been attempted, but has showed to
cause more damage than help.
Vitamin E:
Potassioum aminobezoate (potaba):
This is a form of a vitamine in the
B-complex. Also this substance may help by Peyronie's disease.
Verapamil:
Shock wave therapy: Surgery by Peyronie's disease :
- By the Nesbitt plication one removes tissue opposite to the curve to straighten the penis.
- By Placque excision, the placque is removed and replaced by a graft from the skin of the pubic area.
- Plaque incision with saphenous vein graft. This procedure involves cutting lines in the plaque that allow straightening, and then putting a graft consisting of a part of a vein within these lines.
-In certain cases of Peyronie's disease, surgical insertion of a penile prosthesis (implant) is recommended. This will straighten the penis and make it more stable.
Radiation therapy:
This treatment modality has been tried, but the results are unpredictable
and sometimes the opposite of the intended one.
Traction devices:
Penis pumps: Like traction devices some men also have tried penis pumps to correct the curvature or irregularities by Peyronie's disease, and have reported positive results. Also penis pumps are elswhere used to enlarge the penis. Penis pumps must however be used cautiously to avoid hurting the penile tissue.
A factor in the cause of
Peyronie's disease is an injury to the penis. Preventing penile injury will
prevent some cases of this disease, for example by protecting the penis when
doing hard contact sport or avoiding violent sexual activities. The penis of most men are a little
naturally curved from the birth., sometimes to the left and sometimes to the
right. This congenital curvature can sometimes be greater than one likes it to
be. Such a curvature that have been there all the time is not Peyronie's disease. Sometimes also a man gets an
injury to the penis that destroys some of the erectile tissue. This can also
cause irregular or curved penis. by Knut Holt
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