What is Peyronie’s Diesease? Put simply, Peyronie’s disease is a condition marked by penile curvature, indentation and loss of penile length upon erection. This can be with or without pain.
These deformities of the penis can appear in men of all ages but is most commonly present in men in their 50’s. Not commonly known is the fact erectile dysfunction is also found to occur in up to 90% of men with Peyronie’s disease.
The formation of scar tissue on one side of the penis shortens that respective side of the penis, resulting in a curvature i.e. if the scar tissue is on the right side of the penis, the right side will become slightly shortened creating a pull of the penis to the right.
Listen to Dr Katelaris explain: What is Peyronie’s Diesease (56 second video)
The deformity of the penis is due to plaque formation that is, in fact, a thick inelastic scar. This thick inelastic scar can create curvature of the penis upwards, downwards, or sideways.
So what causes Peyronie’s disease?
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. However this is not always the case.
What is the impact of having Peyronie’s disease?
Individuals with Peyronie’s disease are at risk for the following conditions:
- Penile deformity
- Resulting in indentation, narrowing, or loss of length
- Can interfere with the ability to engage in sexual activity and penetration
- Erectile Dysfunction
- Peyronie’s disease is associated with a reduction in rigidity, or hardness, of erections.
- Correction of the curvature rarely leads to correction of erectile dysfunction.
- If erectile dysfunction coexists with Peyronie’s disease, treatment options exist that will correct both problems
- Psychological impact
- This condition has been recognised to affect a man’s psyche markedly, including causation of depression and anxiety disorders. Appropriate diagnosis and treatment requires the help of an experienced medical professional
What are treatment options?
The goal of therapy is to maintain or regain sexual function by straightening the penis. Treatment should be individualised based on a number of factors including, but not limited to, degree of penile curvature, severity of penile shortening, the presence of penile narrowing, and whether erectile dysfunction is present. There are a number of interventions available including:
- Oral medications
- Topical electric current therapy (iontophoresis)
- Verapamil injections into the plaque
- Mechanical stretching with vacuum devices or external penile extenders
- Surgical penile reconstruction with or without grafting
- Placement of penile prosthesis with straightening
How can the penis be corrected surgically?
There are three techniques to make the penis straight:
- Shortening the longer side of the penis to create equal length on both sides. Although shortening may occur, the amount of shortening is typically no more than 1-2 cm. This procedure is utilised for less severe cases of Peyronie’s disease.
- Scar tissue is cut or partially removed on the shorter side. After removal of this tissue, the defect is filled with a graft. Resultant penile length is approximately equivalent to the longer side of the penis. This operation is reserved for men with severe deformity and no erectile dysfunction.
- For men with erectile dysfunction and Peyronie’s disease, a penile prothesis may be placed followed by penile straightenning with manual modelling. Want to know more about Penile Prothesis and how they work? Click here
What are the risks of surgery?
The key in a successful outcome is utilising the services of an experienced urologist. Dr Phillip Katelaris has over 25 years decorated experience in Urological Practice including treating Peyronie’s disease in Sydney.
Although rare, like any surgery there are risks involved. Please discuss these at length with your urologist to understand any risk application to your personal circumstances. Risks include:
- 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 (usually 1-2 cm if at all)
- Bleeding and infection are complications associated with most surgical procedures but are quite rare with these operations
For any questions on Peyronie’s disease, treatment alternative or pricing arrangements please call into the Doctor’s office on (02) 9477 7904 or fill out the contact form on this page.