Peyronie's Disease and Treatment
Peyronie’s disease causes the penis to bend and become painful during erection. Peyronie’s disease is most often caused by a minor injury to the penis, which causes scar tissue (plaque) to form inside the penis. Typically, curvature associated with Peyronie’s disease is much more pronounced than normally occurring curvature.
Statistics indicate that Peyronie’s disease occurs in about six out of 100 men between the ages of 40 and 70. It can occur, rarely, in younger men. However, Peyronie’s disease may be more common, because some men may be embarrassed by the condition and hesitate to seek treatment.
Causes of Peyronie’s disease
Peyronie’s disease is most often caused by minor trauma to the penis. However, researchers also believe that Peyronie’s disease may have genetic or environmental contributors as well. Men who have a close family member who has experienced Peyronie’s disease are more likely to develop the condition. Men with high blood sugar or diabetes, who use tobacco, or who have had past pelvic-area trauma also are at higher risk of developing Peyronie’s disease.
Peyronie’s disease diagnosis and progression
Peyronie’s disease can be diagnosed through physical exam and ultrasound images of the erect penis.
Peyronie’s disease often progresses through two phases:
- Acute phase: During this phase, which can last from six to 18 months, scar tissue, or plaque, forms. The bending of the penis worsens and erections may cause pain.
- Chronic phase: In this phase, the plaque stops growing and the bending is no longer worsening. Erection may no longer cause pain.
Peyronie’s disease treatment
Occasionally, Peyronie’s disease goes away on its own. More commonly, when pain and discomfort make intimacy uncomfortable or impossible, treatment can provide relief.
At Foothills Urology, we offer numerous treatment options for Peyronie's disease, including:
Although research overall has been inconclusive, some patients report symptom relief from medications including vitamin E supplements, potassium amino-benzoate (sold under the name Potaba); and an anti-swelling agent called colchicine.
Pentoxifylline also is an oral medication used for Peyronie's disease. When taken for several months, the medication may reduce the amount of scar tissue, though exactly how it works isn’t understood.
For some patients, medications injected directly into the affected area can help fix penis curvature associated with Peyronie's disease. Depending on the therapy, you might be given a local anesthetic before the injection.
Many injected medications are administered multiple times over several months. These medications may also be used in combination with oral drugs.
At Foothills Urology, we offer a variety of injectable therapies, including:
- Collagenase. The only medication approved by the U.S. Food and Drug Administration for treatment of Peyronie's disease is collagenase clostridium histolyticum, sold under the brand name Xiaflex. This therapy has been shown to improve penis curvature by breaking down the production of collagen, a protein that might be a key factor in the formation of Peyronie's disease.
- Verapamil. Typically used to treat high blood pressure, Verapamil also appears to disrupt the production of collagen.
- Interferon. This is a type of protein that appears to disrupt the production of fibrous tissue and helps break it down. One placebo-controlled trial showed improvement using this therapy compared with placebo.
When the deformity or pain caused by Peyronie’s disease is severe, and the condition persists for a year or more and does not respond to other treatment, surgery to correct the penis curvature may be an option. At Foothills Urology, we offer the most effective surgical procedures for Peyronie’s disease, including:
- Suturing (plicating) the unaffected side. A variety of procedures can be used to suture the side of the penis that does not have scar tissue. Suturing straightens the penis, although it may result in actual or perceived shortening.
- Incision or excision and grafting. With this type of surgery, the surgeon makes one or more cuts in the scar tissue, allowing the sheath to stretch out and the penis to straighten. The surgeon then may remove some of the scar tissue, and sew tissue into place to cover the surgical area. This procedure is generally used in cases of severe curvature or deformity. Side effects may include erectile dysfunction.
- Penile implants. Penile implants, also called penile prostheses, are an effective treatment for erectile dysfunction, but they can also be used to treat Peyronie’s disease. Surgically inserted implants replace the spongy tissue that fills with blood during an erection. The implants might be semirigid — manually bent down most of the time and bent upward for sexual intercourse. Another type of implant is inflated with a pump implanted in the scrotum. If the implant alone is not completely effective, it may be combined with tissue grafting. Learn more about the benefits of penile implants, including invisibility, permanence and high patient satisfaction.
Following surgery, a dressing is often left on the penis for 24 to 48 hours after surgery to stop bleeding and hold the repair in place.
Most patients leave the hospital the day of surgery or the following day. You may be given antibiotics to take for a few days to lower the risk of infection and help reduce swelling. In addition, we can prescribe medications to ease any pain or discomfort.
Patients should refrain from sexual activity for at least six weeks after surgery.