Peyronie’s Disease

Overview

Peyronie’s disease is a term used to describe a constellation of symptoms which affect the penis. The penis is comprised of two erectile rods called the corpora cavernosa and the urine tube called the urethra. Peyronie’s disease occurs when the corpora cavernosa become inflamed and scar tissue is produced. There are many suspected causes including infection and trauma. Currently, "micro-trauma" to the penis during sexual relations is felt to cause the inflammation and the ultimate scar formation.

Evaluation

Patients with Peyronie’s disease can have different presentations. The most common finding is a "lump," "plaque" or "hard" area in the non-erect penis. Painful erections are another common finding. Lastly, the penis may be curved. Curvature occurs because of the inability for the rods to expand fully due to the scarring of the erectile tissue.

The natural history of this disease is varied. Typically, a male will have an ache or pain with erections which can last up to one year. Peyronie’s disease is considered to be in its active phase when pain is associated with erections. Penile curvature may occur immediately in the disease process, or later as the scar becomes more mature.

Treatment

There is no definite cure for Peyronie’s disease, and many treatment options have been studied. Currently, supportive care and medical treatment for approximately one year is recommended. Vitamin E in dosages of 800 units per day or a medication called Potaba® are often used during the active phase of the disease. Treatments such as radiation, steroid injections and ultrasound treatments have all been attempted.

Treatment for curvature of the penis is individualized. The natural history of the curvature (plaque) will be to either remain stable or gradually improve with time. When a man has a good erection, but the curvature affects normal sexual relations, then surgical excision of the plaque or a straightening procedure are indicated. When a man has a poor erection, then a penile prosthesis is placed to straighten the penis and maintain the erection.

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