What is Peyronie’s disease?

No one wants to talk about a condition that may negatively affect a satisfactory sexual experience, and that is especially true if that condition is penile deformity due to Peyronie’s Disease. Read more about Peyronie's disease

Reference

(1). The Management of Peyronie’s Disease: Evidence-based 2010 Guidelines.

Ralph, D., Gonzalez-Cadavid, N., et al. J. Sex Med 2010; vol. 7

(2). It’s a Guy Thing. Levin, L. Med Update 2007

Named after Francois de la Peyronie, surgeon to Louis XIV of France, Peyronie’s disease can appear in men of all ages but is most commonly present in men in their 50s. 

 

Unknown cause

 The cause of Peyronie’s Disease is not well understood. In most cases, the disease is a result of inflammation and plaque formation after repeated trauma to the penis; most commonly occurring during sexual intercourse.

The deformity of the penis is due to plaque formation that is, in fact, a thick, inelastic scar. This can create curvature of the penis upwards, downwards or sideways. Erectile dysfunction is also a common side effect, occurring in between 58% and 90% of men with the disease (1, 2).

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Signs and causes

Peyronie’s Disease can have a significant impact. As well as psychological distress and penile deformity, many men will also experience erectile dysfunction (ED). The impact of having Peyronie’s Disease

Peyronie’s Disease can cause one or more of the following conditions:

Psychological distress

It’s not uncommon for men with the disease to experience depression and anxiety disorders. Talk to your doctor to discuss appropriate diagnosis and treatment options.

Penile deformity

The disease can result in indentation of the penis, narrowing or loss of length. It can also affect the ability to engage in sexual activity.

Erectile dysfunction

The disease is frequently associated with a reduction in rigidity, or hardness of erections. Unfortunately, correction of the curvature rarely leads to correction of ED. However, if ED coexists with Peyronie’s Disease, there are treatment options that will correct both problems.

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Treatment options

What are the non-surgical treatment options?

What are the non-surgical treatment options?

There are a number of non-surgical interventions available for men with Peyronie’s disease. Non-surgical treatment options

The goal of treatment is to maintain or regain sexual function by straightening the penis. Treatments can include:

  • Oral medications
  • Topical electric current therapy (iontophoresis)
  • Verapamil injections into the plaque
  • Mechanical stretching with vacuum devices or external penile extenders

Treatment should be tailored to the patient’s needs and should take into account the degree of penile curvature, severity of penile shortening, the presence of penile narrowing, and whether there is any erectile dysfunction.

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What are the surgical options?

What are the surgical options?

When other non-surgical treatment options do not work, one of two procedures may be done. Surgical treatment options

References

3. Tutoplast Tissue Sterilization Process, 5686 RI, RTI.

4. Histology of Surgically Implanted Tutoplast Processed Dermis, 4883, David Greenspan.

While it may sound radical, surgical treatment can be an effective way to restore sexual function. There are two techniques: 

  • Surgical penile reconstruction with or without grafting
  • Placement of penile prosthesis with straightening methods

Shortening the long (unaffected) side

The formation of scar tissue on one side of the penis will shorten that side, resulting in a curvature (Figure 1). Shortening the longer side of the penis can help create equal length on both sides (Figure 2). Although some shortening may occur, the amount of shortening is typically no more than 3/4 of an inch. This procedure is usually used for less severe cases of Peyronie’s disease.

penile straighteningpenile surgeryPeyronie's surgery

 

 

Allograft

Scar tissue is cut or partially removed on the shorter (affected) side. After removal of this tissue, the defect is covered with a natural, soft graft material (Figure 3). The graft material offered by Coloplast has been used in more than 2 million implants. (3) It provides a safe, natural support when strength and security are needed.(4)

penis scar tissuepenis scar tissue removal

allograft

The length of the penis after the treatment is approximately equivalent to the longer side of the penis. This procedure is used for men with severe cases of the disease and no erectile dysfunction (ED).

 

Penile prosthesis

For men with ED and Peyronie’s Disease, a penile prosthesis may be the answer (Figure 4), followed by penile straightening with manual modelling.


Click here for more information about Titan® inflatable penile prostheses.

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What to expect?

As with any surgical procedure, there is a lot to consider. Be sure to discuss the possible effects with your doctor and keep reading to learn more about some of the risks associated with these treatments. Find out more

Surgery to correct Peyronie’s disease can result in the complications listed below. If you have any particular concerns, talk to your doctor before deciding on a procedure.

  • Change in penile sensation (usually returns in 1–2 months after surgery)
  • Recurrent curvature (rare if deformity is stable for 6–9 months before surgery)
  • Erectile dysfunction (this is less likely to occur in men with strong pre-operative erections)
  • Penile shortening (minimal, if at all)
  • Bleeding and infection are complications associated with most surgical procedures, but are quite rare with these operations
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Frequently asked questions

Surgery is a big deal, so it’s only natural to have questions. We’ve gathered some of the most common here. Read more

References

7. Peyronie’s Disease: A Guide to Clinical Management. Levine, L., Totowa, NJ: Humana Press, 2007; pp 225.

8. NIH Publication No 09-3923. June 2009.

Q. Will my penis be perfectly straight after treatment?

A: The goal of surgery is not to make the penis perfectly straight, but functional. This is accomplished in 98% (cf. 7) of cases.


Q: Will I regain the former length of my penis?

A: The loss of elasticity that occurs with the disease can reduce the length of the penis. Your length may vary depending on your selection of treatment.
 

 

Q: My erections have become weaker with Peyronie’s disease; will they improve after surgery?

A: The surgery to correct the curvature will not address the rigidity, or hardness of the erections. Erectile dysfunction is a condition that can be treated separately.
 

 

Q: What can I do to improve my erections and make them last longer?

A: Erectile dysfunction is experienced by approximately 30 million men (cf. 8). There are many treatment options that can improve the quality of your erections, including:

  • Oral therapy (Viagra®, Levitra®, Cialis®)
  • Penile injections
  • Vacuum devices
  • Intraurethral suppositories
  • Penile implant

Q: Will my insurance cover this procedure?

A: Insurance plans cover the procedure in most cases. Billing specialists in the physician’s office can help confirm your coverage.
 

 

Q: What should I do next?

A:

  • Make an appointment with a physician specializing in Peyronie’s disease and erectile dysfunction
  • Come prepared with questions
  • Discuss your treatment options
  • Ask if you can speak to a satisfied patient
  • Confirm your insurance coverage

Your urologist will discuss with you which treatment option is most likely to be satisfactory for you.


For more information or to find a qualified physician, visit www.straighttalk.net

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