An Overview of Peyronie’s Disease
Peyronies disease is the development of a significantly bent or curved penis which results in uncomfortable or even painful erections.
Having a curved erection is not unusual and is generally within normal parameters for sexual performance and function. After all, men’s penises vary greatly in shape, size and other attributes. Many partners even find a penis with curvature more attractive. It is when the curve is painful and prohibits normal sexual performance that Peyronies disease may be suspected.
Fibrous scar tissue which has developed inside the penis is known to be the cause of Peyronies disease. Erectile dysfunction may result from Peyronies disease, as the scar tissue can be painful or may cause stress or anxiety which leads to inability in sexual performance. Maintaining an erection can also be difficult for a patient with a curved penis.
Peyronie’s disease sounds ominous, but for some men it diminishes and goes away altogether on its own. In many instances, it does remain. For others, curvature, scar tissue development and pain will grow worse over time. If Peyronies disease leads to erectile dysfunction, the patient should seek treatment.
Common Symptoms of Peyronie’s Disease
Peyronies disease is a disorder which can be discovered suddenly or develop over a longer period of time. There are earmark signs and symptoms common to men with Peyronies disease. These symptoms include:
• Development of scar tissue typically attributed to Peyronies disease, under the penis skin – This scar tissue often feels like lumps or rubber bands.
• Marked curvature of the penis in an upward, downward or sideways bent direction – Some men experience a narrowing of the penis or a change in penis shape. Peyronie’s disease can cause an hourglass shape or indentations to the penis when erect. There may appear to be a narrow and tight band around the penis shaft, much like a rubber band.
• Problems with attaining or sustaining an erection, also known as erectile dysfunction – This is very common to Peyronie’s disease.
• Reduction in penis length – Peyronies disease can cause shortening of the penis, itself.
• Pain in the penis – Peyronies disease and its associated buildup of scar tissue causes pain, whether during or without penile erection.
• Worsening in curvature – Peyronies disease can develop in continual, slow progression, although it is also known to stabilize on its own in many men.
Erectile dysfunction and pain associated with erection may improve over time in men with Peyronies disease without treatment. However, scar tissue and curving of the penis symptomatic of Peyronies disease will most often remain. This lingering curvature is not always the case, but the majority of men do not see a return to normalcy from Peyronies disease without treatment.
Timeline for Seeking Treatment
As is true of any erectile dysfunction or pain in the penis, whether present only during sexual activity or throughout daily life, men affected by symptoms of Peyronies disease or who suspect they may have Peyronies disease should seek professional diagnosis and treatment as soon as possible. Treatment for possible Peyronies disease should certainly occur if and when the patient experiences serious pain or discomfort.
Causes of Peyronies Disease
The precise reason for occurrence of Peyronies disease is not fully known. However, researchers have determined several factors in common with Peyronies disease, which indicate Peyronies disease is present.
Repetitive injury to the penis is thought to be the root cause of Peyronies disease. Some injuries may have occurred in sports activity, as part of an accident, or even during sexual activity. While any trauma to the penis sounds painful, most men affected by Peyronies disease do not even recall specific incidents or trauma which could be held accountable for their development of Peyronies disease.
Regardless of the injury causing Peyronies disease and its associated scar tissue, doctors do know that the scarring forms in a very haphazard manner. Those formations of Peyronies disease scars may become detectable nodules felt when handling the penis. Other patients of Peyronies disease note that they could feel the curvature changes and development over time, as if the Peyronies disease related scarring was pulling at the penis as those scars grew.
The corpus cavernosum, the spongy tubes on each side of the penis containing many blood vessels, play a major role in development of an erection. Both of those corpus cavernosa are contained within their own elastic sheaths of tissue known as tunica albuginea. As an erection occurs, those tunica albuginea stretch.
During sexual arousal, these chambers are filled with blood. The increased blood flow causes the penis to become larger, harder and straighter, into an erection ready for sexual activity.
As part of Peyronies disease, scar tissue prevents erection associated stretching of the penis. Peyronies disease causes the penis to bend or misshapen under the pressure of the restrictive scarring. This is how pain results, through pulling of the scar tissue and engorgement of the penis without a resulting straight erection.
In men whose Peyronies disease develops gradually over time, it may seem that the development of Peyronies disease is not as a result of accidents or trauma to the penis. There is some belief that genetic factors or other health conditions may lead to Peyronies disease, as an alternative to trauma damage.
Who is at Risk for Peyronies Disease?
Although injury to the penis as a cause for Peyronies disease can affect any man, some health conditions and other factors are believed to create risk for development of Peyronies disease. Some men may be more susceptible to the poor healing of wounds and buildup of scarring that cause Peyronies disease.
Risk factors for Peyronies disease may include:
• Hereditary causes – Men who have a family history of Peyronies disease, such as in a father or brother, may also be at heightened risk for development of Peyronies disease.
• Disorders of connective tissue – Men with other connective tissue disorders or diseases, such as those with Dupuytren’s contracture, may be at increased risk of development of Peyronies disease. Dupuytren’s contracture is similar to Peyronies disease, in that it is a development of a scar much like a cord across the palm. That scarring pulls fingers inward to the palm, just as Peyronies disease scarring curves the penis.
• Aging – Peyronies disease is more commonly seen in men of more advanced age. Tissues in aging men may be more susceptible to Peyronies disease, due to longer and more difficult healing periods for aging tissue.
• Smoking – Peyronies disease is more common among smokers than non-smokers, although both groups are affected by Peyronies disease.
• Some types of prostate surgery – As a result of surgical procedures to the penis, prostate and other surgeries of the genital region, Peyronies disease may develop.
Complications Common as Part of Peyronies Disease
Peyronies disease may differ greatly from individual to individual. Some men may experience more detectable scarring than others, some more pain, others greater issues with erectile dysfunction.
Complications that are common to Peyronies disease include:
• Erectile dysfunction – The Peyronies disease patient may struggle with sexual performance. Getting and maintaining an erection may become more troublesome as part of the condition itself, or as associated with the stress and anxiety of having Peyronies disease.
• Overall inability to have sexual intercourse – Curvature of the penis, pain and partner discomfort because of Peyronies disease may hinder sexual intercourse.
• Embarrassment, anxiety or stress due to a bent penis – It is natural to feel loss of confidence and increased stress during physiological changes associated with Peyronies disease.
• Partner stress or relationship anxiety – A patient of Peyronies disease with a curved penis may recognize his partner suffers from anxiety due to the condition or Peyronies disease may cause general relationship stress.
• Reproductive difficulties – Peyronies disease patients may find that the crooked penis associated with Peyronie disease may create difficulty in reproduction due to problems during sexual intercourse.
Preparing to Visit a Doctor
Upon noticing curvature, pain or other symptoms which may indicate Peyronies disease, a doctor’s visit should be scheduled. A family doctor or general practitioner can diagnose problems of this nature or a specialist referral to a urologist may be provided.
In order to ensure both patient and doctor communicate well for an optimum healthcare appointment, there are some things that a man believing he may have Peyronies disease can do to prepare for the appointment. Those are:
• Make a list of all current and recent symptoms or overall physical changes. Whether Peyronies disease or a curved penis seems to relate to those changes is not important.
• Note any recent lifestyle changes or major stress factors in life which may contribute to sexual dysfunction or health differences.
• Provide all prescription information, as well as non-prescriptive medications and supplements such as vitamins.
• List any known injuries to the penis, including general dates if possible.
• Ask family members like brothers and father if they have developed Peyronies disease.
Patients visiting a doctor about suspected Peyronies disease or due to a bent penis should ask several questions of their physician. Some of those may be:
• What tests will be given to diagnose the problem?
• What types of treatment will be recommended?
• Is it thought that the crooked penis and other symptoms will improve or worsen?
Of course, the physician will likely lead the appointment with several questions of the patient. The health care practitioner working to diagnose Peyronies disease or other condition might ask:
• When did the penis curve and scar tissue first become noticeable?
• Has the penis grown more curved over time?
• Are erections possible? If erections can be obtained and/or maintained, are they painful?
• Have there been any memorable injuries to the penis?
Diagnosis of Peyronies Disease
Scar tissue is detectable through a physical exam in most cases where Peyronies disease is suspected. Other tests which may be administered toward a definite diagnosis include:
• A physical exam including measurements as a gauge of changes over time.
• Photographic records – The doctor may request photos of the erect penis from home, in order to see the curvature or changes experienced during erection.
• Ultrasound or other diagnostic tests to indicate presence of scarring, blood flow and any abnormalities.
Peyronie’s Treatment
There are several treatment options for patients of Peyronies disease, if the doctor has made a definite diagnosis. Those treatments include:
• Medication to reduce scar formation and pain, in turn reducing penis bend. Such medications may be administered orally, through injections or by topical gel application.
• Surgery, if severe deformity, major discomfort or complete inability to engage in sexual activity is present. Surgery is generally done when the penis has reached its final curvature.
• Other treatments including iontophoresis and non-drug treatments being researched at this time. Some treatments presently being studied include shock wave therapy, penile traction therapy and vacuum devices.
Dealing with Peyronies Disease
Like any other form of erectile dysfunction, Peyronies disease may cause significant relationship stress or personal anxiety for the patient and his partner. Do not be afraid or embarrassed to seek help or take some of the following steps to help in dealing with Peyronie’s disease:
• Communicate openly with partner(s) about Peyronie’s disease and its affects on sexual activity.
• Talk to a mental health professional who specializes in sexual relationships, to gain support and open communication with your partner.