Peyronie's Disease - A Fact Sheet

Summarized by Robert W. Griffith, MD
October 11, 2005 (Reviewed: October 17, 2005)

This fact sheet is taken, with permission, from the Sexual Dysfunction Association website. The Sexual Dysfunction Association is a UK charitable organization that primarily aims to help sufferers of impotence (erectile dysfunction), and their partners, and to raise awareness of sexual problems among both the public and health professionals. Robert Griffith, Editor

Introduction

The aim of the fact sheet is to provide useful information about Peyronie's disease. This rare condition affects up to 1% of the male population.

What is Peyronie's disease?

Peyronie's disease is the presence of fibrous plaques within the shaft of the penis. The plaques are formed in the tissue surrounding the main erectile bodies, the tunica albuginea, thus with erections the plaque will cause bending and angulation of the penis. Sometimes the bending is so marked that it makes sexual intercourse impossible.

The exact cause is not yet fully understood and many factors are thought to be involved. There may in some cases be a family history or the patient themselves may have Dupuytren's contracture, where there are similar fibrotic plaques in the palm of the hand.

The condition can affect men of any age and present with varying degrees of curvature and severity, which is most visible when the penis is erect.

Why is it called Peyronie's disease?

Peyronie's disease was named after Francois Gigot de La Peyronie who, in 1743, described the characteristic fibrotic, sometimes calcified plaque, under the skin of the penis.

What are the main effects of the disease?

The three main symptoms of Peyronie's disease are pain with erections, a palpable lump in the shaft of the penis and curvature of the penis with erections. Not all these symptoms may be present and their severity can vary widely.

Pain may occur initially with erections and subside without treatment. At this stage, the patient may start to become aware of a thickening in the shaft of his penis. As the plaque develops, the penis may become more noticeably curved when erect. If this curvature increases to a severe angle sexual intercourse may become uncomfortable for both partners or impossible.

Some patients may develop erectile dysfunction problems with the development of Peyronie's disease; this may have a psychological element secondary to the physical changes caused by the disease.

Who can get Peyronie's disease?

Any man can develop Peyronie's disease. The average age of onset is 50 years, but it can occur in men as young as 18 years. This condition may in fact affect as many as 2% of the population, but many men are too embarrassed or afraid to go to their doctor.

What should I do if I think I have Peyronie's disease?

Go to see your doctor as soon as you feel any pain or abnormal lumps in your penis. If Peyronie's disease is diagnosed, ask your doctor to explain about the condition and the treatment options that are available.

If your doctor is unable to answer your questions, request a referral to a consultant with a special interest in male sexual health problems.

Sometimes, in about 13% of patients the disease will clear by itself, but this may take several years. However, there are treatments available and the sooner the condition is treated the earlier it can be helped.

What are the treatment options and how long will the cure take?

It is important to remember that many men with Peyronie's disease do not require any treatment. Over the years a large number of treatments have been used, but no single treatment has been shown to be effective in all cases.

In the early stages, oral tamoxifen has been shown to produce an improvement by preventing the formation of fibrous plaque; although this drug is chiefly used for the treatment of breast cancer the two conditions are not related.

Vitamin E is a simple and sometimes effective way to ease the pain and deformity of the disease. It will not alter any underlying erectile dysfunction.

Verapamil, a calcium channel blocker often used in the treatment of high blood pressure, has been shown to decrease the plaque size and pain in Peyronie's disease when injected directly into the plaque.

Other treatments include colchicine, potassium aminobenzoate (Potaba®) and interferon treatment.

There have been recent trials in the treatment of Peyronie's with extracorporeal shock wave therapy (ESWT); although initial results have been promising, the long-term outcome is still to be determined.

Surgery is only to be considered once the disease has been present for a sufficient amount of time to have stabilized. At this time about 10% of patients will find surgery necessary if the deformity is such as to prevent sexual intercourse. The operation may be to remove tissue opposite to the penile curve - the Nesbit procedure - in order to correct the curve. Alternatively, an area of vein or in some instances a graft can be put within the fibrous plaque thus elongating the area. Excision of the fibrous plaque is not advisable as this often leads to impaired erections. In some cases where the erections are already impaired insertion of a prosthesis may be suggested.

What can I do to help myself?

Find out as much as you can about the disease and the treatments; if you feel that your doctor is unable to help there are clinics where you can get advice. Support and understanding from your partner is a great help and relieves a lot of the worries and pressure.

Source

• Sexual Dysfunction Association website www.sda.uk.net

Related Links
National Institutes of Health: Peyronie's Disease
Sexual Dysfunction Association (UK)
Mayo Clinic: Peyronie's disease

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