Peyronie's disease is a medical condition in which problem
in the penis is caused due scar tissue that form inside the penis called
plaque. These plaques that form in the penis are fibrous tissues that appears
inside the penis’s erectile tissue. Over a period of time, the plaques in the
penis tend to grow and deform the erection of the penis causing it to curve.
Usually it is the upper part of the penis that is affected
by the Peyronie's disease. But many times even the lower part of the penis is
affected by it and sometimes these plaques form on both sides of the penis.
Though the medically the cause to this disease has not yet been known or
confirmed, it is believed that at times injury or some kind of infection can
lead to this problem.
The Peyronie's disease commonly affects older men in the age
group of 30 years to 80 years. This disease affects around three percent of the
men in this age group. This medical condition is difficult to cure as no
definite treatment to it has been found yet. Men who suffer from this disease,
around 16 to 20 percent of them tend to develop other such plaque related
problems. They develop other fibrous tissues like the Dupuytren’s contracture.
This leads to the shortening or contracting of the palms connective tissue that
results in the fingers, one or more to close.
The number of people who develop this disease is not
accurately known as there are many who are embarrassed enough to visit the
doctor for treatment. It is roughly suggested that 3 to 9 men out of 100 suffer
from this disease. It is commonly found in men who are in there fifties. There
are few teenagers as well who develop this disease but it is rare to find the
congenital form.
The Peyronie's disease is common in people who suffer from
other ailments like diabetes, hypertension or high blood pressure,
hyperlipidemia and in people who suffer from ailments that affect the heart
muscle. It could even harm people who smoke and drink a lot.
Causes of Peyronie's disease
The cause of Peyronie's disease is yet to be known or
confirmed. The experts suggest that in case there is some damage to the blood
vessels in the penis due to hitting or bending, it can cause blood leakage
inside the penis. This leakage of blood that is not visible from outside can
areas certain areas of the penis where there is no contact of blood. This
contact of blood in turn leads to the reaction of the immune system in the body
that results in scarring.
Another reason suggested by the experts is that it could be
genetic. The experts say there is a possibility that the genetic make up of the
patient is defective or it could be that body does not generate enough male
hormone testosterone. When we say genetic, it means that this medical condition
could have been passed on through cell special codes in the body called genes.
Many times babies are born with this disease but it is not recognizable till
the time sexual maturity of the baby develops.
Symptoms of Peyronie's disease
The most noticeable symptom of this disease is that of
painful erections. Also, if you find the skin around the shaft of the penis to
be thickening then it could well be Peyronie's disease. In this disease when
the penis is in an erected position than you will notice that the penis is
angular, curved or distorted. Though this can be easily observed when the penis
is erect it can often be diagnosed even when the penis is in a flaccid or soft
position.
The Peyronie's disease is in a painful stage in the first 18
-24 months of its existence. This phase is commonly known as the inflammatory
phase. After this phase the pain will subside but the deformation of the penis
continues to happen. This deformation stage of the penis is called the fibrotic
stage and at this stage there is no pain but the scarring continues to happen.
And mostly it has been observed that men who suffer from this disease generally
go in to depression.
The level of the Peyronie's disease can vary from being
mild, moderate to even being severe. This disease can all of a sudden be
visible and there are times when it makes a slow progress. Again in many case
the disease takes from weeks to months to be diagnosed. The progression of the
symptoms of this disease could include the following:
·
Some discomfort or a small ache in the penis
could be felt.
·
A painless lump could be felt or could be
visible at the point of ache or discomfort
·
As the plaque will spread it will also begin to
contract. This will lead to the kinking
or bending of the penis to the side that is affected.
·
The erections that are supposed to be hard will
be softer comparatively.
·
The erection of the penis will become painful
and uncomfortable.
·
There could be more than one fibrous tissues or
plaques formed in the penis
Penis Structure
In the penis there is an erectile tissue that is called the
corporal bodies or by a more scientific name corpora cavernosa. These two
tissues actually look like there are two rods that run through the length of
the penis. These rod like tissues have blood vessels. When the penis is
sexually aroused, there is a nerve in the penis that supplies blood to the
penis. This nerve at the time or arousal of the penis allows the empty vessels
of blood in it to be filled with blood thus, causing erection of the penis.
The Peyronie's disease has its formation in the membrane
that the corporal bodies are covered with. This disease when in the advanced
stage can continue growth and affect the erectile tissue of the penis. The
plaques that form in the penis due to this disease causes a bend in the penis
that in turn stops the blood flow to the penis’s corporal bodies. This when the
penis has problems in erection.
Deformed Penile Erections
Usually the plaque that forms in the penis due to this
disease appears on the top part of it. This causes the penis to bend towards
the plaque that is upwards. In other cases, the formation of the plaque is in
the underside of the penis. This results in the penis to curve downwards.
Again, in rare or very few cases the penis experiences the growth of plaques on
both its side that is the upper as well as the lower side. When both the sides
of the penis are affected it leads to the distortion of the penis or it
shortens.
Peyronie's Disease Diagnosis
The symptoms of the disease like curvature; angulation,
painful erections and other deformity of the penis shaft are indication enough
for the doctor to confirm that you have the Peyronie's disease. However, the
doctors want to be sure before starting with the treatment. So they check the
penis and measure its distortion or its bend while it is in an erect position. There
are a number of tests that helps in diagnosing the Peyronie's disease. These
are:
·
Medical History
·
Sexual History
·
Physical Examination
·
Photographs Taken at Home of the deformed penis
·
Ultrasound scan of the Penis
·
Another accurate wait to diagnose the disease that
doctor’s use is by injecting the shaft of the penis or by using the vacuum pump
that helps to stimulate erection.
There are many doctors who also ask their patients to answer
a short questionnaire that is basically to assess how much this medical
condition is affecting your personal life. Though there are no specific tests
that the patients are asked to undergo, however, in some cases you may be asked
to go through a scan that is called the duplex ultrasound. This ultrasound is
mainly done to check on the blood circulation of the penis.
Peyronie's Disease Treatment
Before you decide on the treatment for your Peyronie's
disease, you also have the option of not wanting to take any treatment if you
feel:
·
The Peyronie's disease in your case is at its
first stage or is a mild version of it that does not cause any discomfort or
pain to you.
·
You may also want no treatment for this
condition if you are sexually not active.
·
And, if you are not facing any problem with your
sex life than too you may choose not to be treated for it.
If you want to go for the treatment of this disease then
there are many non-surgical options available to help you cure. Research has,
however, proved that there is no guarantee of these treatments to cure the Peyronie's
disease in all the patients who suffer from it.
The non-surgical treatments that doctors use to cure this
disease are:
Oral Medicines:
There are medicines that have been advised by doctors for treatment of this
disease in the past. These are: vitamin E, Colchicine, tamoxifen,
pentoxifylline, acety-L cartinine, propoleum and para-aminobenzoate. Among all
these medicines, however, it is only the para-aminobenzoate that is at par with
the European medicinal guidelines and also has a license in UK for use in this
medical condition.
Medicinal Gel for the
Exterior of the Penis: The gel that is recommended in this condition is the
topical verapamil. Application of this gel has proved to effective in the past
as it helps in stopping the thickening of the fibrous tissue in the penis and
also reduces the bend and curve in the penis. It does give significant results
provided it is used diligently over a period of nine months.
Stretching: The
more technical name for stretching in the medical world is external penile
traction. In this treatment, there is a device that needs to be worn on the
penis and it stretches the penis. Use of this device has shown some effective
results as it lessens the penis deformation and also increases the length of
the penis
Injection in to the Scarring
Tissue: In this method various medicines have been tried in the past like,
interferon, verapamil and clostridial collagenase that is a substance that has
been very recently approved in the USA by the FDA. Research has shown that use
of these medicines have resulted in the improvement of the bend of the penis,
in the size of the plaques and also resulted in elimination of pain.
Electrical Currents:
The more technical name to this treatment is the Iontophoresis. In this treatment
a medicine is applied to the penis and then a electrical current is passed
through it that helps the medicine to penetrate deep inside the penis tissues.
Vacum Device:
This is similar to the traction treatment that creates vacuum around the penis
when applied and results in stretching of the shaft.
Surgery
Among all types of treatments discussed above surgery is the
only one that has medically proved to have a positive guaranteed affect on the Peyronie's
disease. With this treatment the only condition you will have to bear is that
the Peyronie's disease should be in its settled staged with no further changes
to its condition. Thus, you may have to wait up to 12 to 18 months to be
undertaking this surgery. There is also a risk of the penis being shortened due
to surgery and also the chances of the penis being distorted again. And, if you
have tight foreskin around your penis than then it may need a circumcision
after surgery to avoid it from getting tighter.
The surgical options available to you as a patient of Peyronie's
disease are:
·
Laser
Surgery: Thinning of the plaque is
done using carbon dioxide laser.
·
Plication:
In this the normal tissue is not removed rather it is folded in itself.
·
Extracorporeal
Shock-wave: In this treatment
sound wave is used to create vibrations that helps in breaking down the fibrous
plaques. This surgery is done using sedation where a device outside helps
create the sound wave outside the body.
·
Cutting
out the Plaque: this procedure at times is combined with prosthesis to
tackle any shortening.
The
Nesbit Tuck: This procedure usually involves removal of
tissues around the penis that may at times also result in the shortening of the
penis.
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