Dr. Katelaris on 2GB – Health Matters Podcast

Recently Doctor Katelaris was featured on the Health Matters podcast on 2GB, discussing Peyronie’s Disease.

It’s unclear how many man suffer from Peyronie’s Disease as most are too embarrassed to speak to their doctor, a concerning fact highlighted by Sydney Adventist Hospital Urologist Dr Phi Katelaris.

Content originally posted here

Transcript:

John:
Each week we speak with someone from the SAN Hospital, one of the great institutions in this country about medical matters. This one today is something you don’t hear talked about very often. And in fact your instinct is to say, well, do I really wanna talk about this? What we’re talking about is Peyronie’s disease, which is also known. Let’s be straight up about it. A curved penis. Now I’m surprised by this number 9% of Australian men suffer from this. It’s named after a French surgeon, Peroni. He was the personal physician to King Louis the 15th he discovered the disease in 1743 not sure that the King had it, but it is under reported because there’s a bit of nervousness, a bit of embarrassment. We know that men are afraid to talk about any of their medical conditions. So you can understand why there might be some concern about talking about this. So let’s talk about it. And a urologist from the SAN Sydney Adventist Hospital Dr Phil Katelaris, joins us on the line. Doctor, good evening to you.

Dr. Katelaris:
Good evening John.

John:
Now, I mean, your view here is that we can and should talk about it and in fact, men are willing to talk about it.

Dr. Katelaris:
Yes. Men often won’t bring it up, but they certainly appreciate their doctor being frank and upfront. So if the doctor says to a man, do you have any problems getting an erection? Is that something you want to talk about? That sort of opening statement is appreciated by men with these sort of problems.

John:
Yeah. The, the, I guess chicken and egg situation, uh, would be a GP or a specialist who asked that question. Would you ask that question because of the, there’s a problem down there that they are trying to address.

Dr. Katelaris:
Yes. Often it’s the wives who prompt the men to go and talk about it. So that question comes about through many different ways. But the important thing is the doctor has to be sensitive to what’s behind the question. Now, some men will just come out and say, doctor, I’m really stressed. My Penis is bent at 90 degrees and I just can’t penetrate. Or they might say it’s bent and I can’t even get an erection. And if they say that, it’s very important to just encourage open communication because Peyronie’s disease as you correctly said is a curved penis. Now, most men who have this problem, we don’t know what, causes it. Some men have suffered what we call a rectal trauma, meaning that the penis has been accidentally hyperextended during sexual intercourse. But the majority of men, I get it, the scarring in the penis, we don’t know why it’s nothing they’ve done or haven’t done, but we need to talk about it so we can fix it.

John:
Yeah. And when you say 90 degree, we’re talking about a significant curve here. And I see this, the plaque, is that what we’re talking about in terms of the, the damage,

Dr. Katelaris:
The plaque or all fibrous scar tissue is rigid and it, and it’s not a elastic like the rest of the penis. So it tethers the penis and causes the deformity.

John:
Okay. So how do you diagnose it? I mean it’s, obviously there, but to diagnose what’s there and what can be done. How’s that done?

Dr. Katelaris:
The diagnosis is very simple. It generally there’s a palpable lump within the body of the penis or men come along saying my penis was one straight and now it’s bent. Now men come along feeling that the lump is cancer in the penis naturally enough. So the first thing that we need to tell them is it’s not cancer. You know, you’re not going to lose your penis. This is Peyronie’s disease and when we examine the men, we can feel obviously an obvious palpable lump. So there’s no real difficulty with diagnosis. The challenge is more in helping them.

Dr. Katelaris:
Now, some men have Peyronie’s disease, a palpable lump, a very mild curve. They don’t need treatment, they just need reassurance. And for a lot of men, it doesn’t progress beyond that mild form. Now, if a man is getting a good direction but it’s too bent to penetrate, there are two very good reconstructive operations that we can do. One’s called a nesbits plication, where we straighten the penis under a general anesthetic and the other is called an incision and craft. This is a more complex reconstruction, that we reserve for a very bent erections. Now, if men have a very bent direction and cannot get an erection, we fixed those main by putting in an inflatable penile prosthesis, because this device will straight in the erection as well as restoring the ability to get an erection and penetrate.

John:
Yeah. So can people be predisposed to this? How does it come about? How does it happen?

Dr. Katelaris:
Well, as I say, a very small percentage of men get it because they’ve had erectile trauma, but the majority of men get it for no known reasons. It’s a bit of a mystery disease in that sense. The interesting thing is that 10% of men who, who get Peyronie’s disease also have a contracture of the index of the ring finger or toe. So it’s an immune response to cells in the body called fiber fibroblasts. I see also a lot of them, uh, are clinically depressed. I guess the reasons there are obvious [inaudible] yes. I mean, any man who I find she’s [inaudible] to becomes anxious and depressed.

John:
So when you, when you tell them and explain what you’ve just explained to us, I imagine there’d be a wave of relief because they finally got an answer for what, what’s been troubling them.

Dr. Katelaris:
Yes you’re correct. Once you talk about something that’s causing stress and anxiety, a burden is lifted off the shoulders and then the conversation comes around to, well, doc, what can we do to fix it? Right. Because men do have a Mr fix it mentality and they relieved when they given an effective management plan.

John:
I mean, you know, what sort of age are we talking about here?

Dr. Katelaris:
The average age is mid fifties, but can, it can occur in men of any age.

John:
Does it affected fertility?

Dr. Katelaris:
Well, it doesn’t affect fertility other than it, it affects the delivery system. So if a man can’t penetrate because his penis is bent then clearly he can’t deliver the goods. Once we straighten it, then he is right for fertility.

John:
Yes and, and as you’ve explained, cause I mean you say there’s a range of things that you can do a whole range of treatments. So they’d be, I mentioned even in the most extreme cases, you’re able to explain a range of things that can provide them with a solution.

Dr. Katelaris:
Yes, that’s correct. As I say, it ranges from reassurance, no treatment necessary through to surgical reconstruction, which is very successful for the majority of men.

John:
Yeah. And look on that number I mentioned earlier, approximately 9%, there’s one in 10 how many of them do you suspect them? And I’m assuming that that’s based on samples and people that you’ve seen. How many do you think might be suffering from this and just aren’t putting their hand up or just haven’t reached out for help?

Dr. Katelaris:
Exactly. That is an underestimation because men suffering, silence for a lot of medical conditions. We don’t really know the full extent of it. But suffice it to say it’s a relatively common condition.

John:
Okay. So your recommendation to anyone who may, uh, may be, uh, suffering from this may think they are suffering from this or someone that knows someone. Your recommendation would be what your GP would be. Your first stop was that we’re, Yep.

Dr. Katelaris:
Yeah. If a man’s got a palpable lump in the penis, a bent erection, or he can’t get an erection, go to the GP, talk openly about it and get an appropriate referral to a urologist who sub specialises in this area.

John:
All right. We’ll look at something I’m sure for a lot. A lot of our listeners would not be aware of this. They’ve learned a hell of a lot in the last 10 minutes. And as you say, there’d be a proportion of people listening to us right now who might be thinking and that call to the GP. So I really appreciate this evening Dr Phillip Katelaris. Thank you so much for your time.

Dr. Katelaris:
Oh, you’re welcome.

John:
From the Sydney Adventist hospital here on nights.