Description

Disease of peyronie's (pay-roe-NEE) is a disease in which fibrous scar tissue in the deeper tissues beneath the skin of the penis. This causes curved, painful erections. You can also make the shorter penis while erect. Disease peyronie's disease is not caused by the cancer.

Penises vary in shape and size. So having a curved erection is not always a matter of concern. But peyronie's disease causes a severe bend or pain in some people.

This may prevent you to have sex. Or you can make it difficult to get or maintain an erection, which is also called erectile dysfunction. For many people, the disease of peyronie's disease also causes stress and anxiety.

Peyronie's disease rarely goes away on its own. In most people with the condition, will be left as is or it can worsen slightly early. Early treatment, shortly after obtaining the condition can prevent it from getting worse or even improve symptoms. Even if you have had peyronie's disease for some time, the treatment can help relieve symptoms such as pain, the curve and the butter.

Symptoms

Peyronie's disease symptoms of the disease may start suddenly or develop over time. The most common symptoms include:

  • Scar tissue. The scar tissue associated with peyronie's disease also is called plaque. It is different from the plaque that can build up in the blood vessels or in the teeth. You can feel under the skin of the penis as flat lumps or a band of hard tissue. The area on the scar tissue may feel tender.
  • A curve in the penis. The penis may curve upward or downward, or is bent to one side.
  • The problems of erection. Peyronie's disease can cause problems getting or keeping an erection. This is also called erectile dysfunction. Often, however, people with peyronie's disease says that erectile dysfunction prior to the start of your penis symptoms.
  • Shortening of the penis. The penis can be shorter during erection due to peyronie's disease.
  • Pain in the penis. This symptom may occur with or without an erection.
  • Other changes in the way the penis looks. In some people with peyronie's disease, the erect penis may look narrow or bleeding. Could even make into an hourglass-like shape, with a tight, narrow band around the shaft.

The curve and shortening of the penis associated with peyronie's disease may worsen with time. The physical changes in the penis often get worse or stay the same during the first year to year and a half.

Pain during erection usually improve within 1 to 2 years. The scar tissue, shortening of the penis and curve often remain. It is not common, but the curvature and the pain of peyronie's disease may improve without treatment.

When to see a doctor

Consult a health care professional if you notice symptoms of peyronie's disease. Early treatment gives the best chance to improve the condition or prevent it from getting worse. If you've had the disease for some time, to obtain a health care check-up if the pain, the curve, the length, or other changes to disturb you or your partner.

Causes

The exact cause of the disease peyronie's disease is not clear. But various factors seem to be involved.

It is thought that peyronie's disease is most often the result of repeated injury to the penis during sex and vigorous. But the penis could also be injured during sports or accidents. Many people with peyronie's disease may not remember a specific injury that led to your symptoms.

During the healing process after an injury to the penis, scar tissue forms. This can lead to a lump you can feel or to a curve in the penis.

To each side of the penis contains a spongy tube called a corpus cavernosum of the penis. These tubes have many small blood vessels. Each of the corpora cavernosa is enclosed in a sheath of elastic tissue called the tunica albuginea (TOO-nih-kuh al-BYOO-JIN-e-uh). The sheath extends during an erection.

When you become sexually aroused, more blood flows to these cameras. As the chambers fill with blood, the penis expands, straightens and stiffens in an erection.

In peyronie's disease, when the penis becomes erect, the area with the scar tissue does not stretch. As a result, the penis bends or passes through other changes. This can be painful.

In most people, the peyronie's disease symptoms appear slowly and not appear to be linked with an injury. Researchers are studying whether the peyronie's disease can be tied to a genetic trait or certain health conditions.

Risk factors

A minor injury to the penis does not always lead to peyronie's disease. Several factors may contribute to the poor healing of the wound and the scar tissue that may play a role in peyronie's disease. These include:

  • The history of the family. If a family member has peyronie's disease, you have a higher risk of the disease.
  • Diseases of the connective tissue. People who have certain conditions that affect the connective tissue in the body seem to have a higher risk of developing peyronie's disease. For example, some people with peyronie's disease also have a thick wire under the skin of the palm that you can pull the fingers towards the inside. This is called Dupuytren's contracture.
  • Age. Peyronie's disease can occur at any age. But it becomes more common between the ages of 45 and 70 years. Curvature of the penis in younger men with less frequency due to peyronie's disease. It is more commonly called congenital curvature of the penis. A small amount of curvature in young men is typical and not relative.

Other factors that could be linked to peyronie's disease. These include certain health conditions, smoking and some types of prostate surgery.

Complications

Peyronie's disease can lead to problems that include:

  • Not be able to have sex.
  • Difficulty achieving or maintaining an erection, also called erectile dysfunction.
  • Anxiety, stress, or depression about the challenges of having sex, or the way your penis looks.
  • The stress in his relationship with his sexual partner.
  • Trouble having a child, because it is difficult or not possible to have sex.
  • The shorter of the length of the penis.
  • Pain in the penis.

Diagnosis

Health professionals can often find out if a person has the disease of peyronie's doing a physical exam. Tests may also be done to rule out other conditions that can cause similar symptoms.

You may need the following tests:

  • Test físico.Su health care professional will feel your penis when it is erect to find out the location and the amount of scar tissue. The length of your penis can also be measured. If the condition worsens, this measure helps to determine if the penis has become shorter. Your doctor may also ask you to bring in photos of his erect penis taking in the house. This can help to determine the degree of curvature, the location of the scar tissue or other details that may guide the treatment.
  • Other exámenes.Su a professional doctor may order an ultrasound or other tests to check your penis when it is erect. Before the test, the more likely it is to receive an injection directly into the penis, which helps you to become erect. The ultrasound method is the most commonly used test for the penis of conditions. Uses sound waves to produce images of soft tissues in the interior of the body. These tests can show the presence of scar tissue, blood flow to the penis and any other spot signs.

Physical exam. Your health care professional feels your penis when it is erect to find out the location and the amount of scar tissue. The length of your penis can also be measured. If the condition worsens, this measure helps to determine if the penis has become shorter.

Your doctor may also ask you to bring in photos of his erect penis taking in the house. This can help to determine the degree of curvature, the location of the scar tissue or other details that may guide the treatment.

Other tests. Your healthcare provider may order an ultrasound or other tests to check your penis when it is erect. Before the test, the more likely it is to receive an injection directly into the penis, which helps you to become erect.

The ultrasound method is the most commonly used test for the penis of conditions. Uses sound waves to produce images of soft tissues in the interior of the body. These tests can show the presence of scar tissue, blood flow to the penis and any other spot signs.

Treatment

Treatment options for the disease of peyronie's disease depend on how much time has passed since you began to have symptoms.

  • Acute phase. As scar tissue forms, the changes in the curve or the length of the penis become worse. You may also have pain during erection. The acute phase can last from 5 to 18 months.
  • Chronic phase. The scar tissue in the penis stops growing, and your symptoms become stable. You also do not have any pain in the penis or the changes in the curve, length, or other aspects of the penis. The chronic phase, which occurs later in the peyronie's disease.

The acute phase of peyronie's disease treatment

For the acute phase of the disease, treatments include:

  • Traction therapy. When used early in the process, a device that has the penis in a crib and applied stress can be useful. This is called penis traction therapy. Prevents the length of the loss, and the limits of the curve.
  • Drugs. Some medicines that are taken by mouth, or in the throws are the options at this stage. Some medications that have been used in the past clearly don't work. Others may or may not help. Your health care professional is likely to talk with you in more detail.

Surgery is not recommended in the acute phase of peyronie's disease. It is not a treatment option until the condition ceases to be worse and the pain goes away. This reduces the likelihood of needing a second surgery.

Chronic phase of the disease peyronie's disease treatment

For the chronic phase of the disease, treatment options include:

  • Watchful waiting, in which your health care team watches his condition closely and gives you the treatment if the symptoms get worse.
  • Injections into the scar tissue.
  • Stretching devices, also called "traction" of the therapy.
  • Surgery to straighten the penis.

These treatments can be done alone or combined with another.

Oral medications that are taken by mouth is not recommended in the chronic phase. They have not been shown to be effective in this stage of the disease.

Drugs

The oral medications that have been used to treat peyronie's disease. But research has shown that many of them do not work consistently, and are not as effective as other treatments.

In some people, the drugs are injected directly into the scar tissue in the penis can reduce the curvature and the pain associated with peyronie's disease. Depending on the treatment that is given the medicine that goes in the skin called a local anesthetic to prevent pain during the shoot.

If you have one of these treatments, you'll likely receive more than one shot over many months. Injection of medication can also be used in conjunction with oral medications and / or therapy of traction.

Drugs given by injection include:

  • Collagenase clostridium histolyticum (Xiaflex).This is the onlyFDA-approved medication for peyronie's disease. It is approved for use in adults with moderate-to-severe, and the curve of lumps under the skin that can feel. This treatment has been shown to improve the curve and bothersome symptoms associated with peyronie's disease. The treatment works by breaking down the protein accumulation of collagen in the scar tissue causes the penis to curve. The collagenase seems to work best when used in conjunction with the traction therapy or other treatment is called a "model." With the modeling, a health professional will bend the penis in the opposite direction of the curve.
  • Verapamil. This medicine works by disrupting the scar tissue and prevent the formation of scar tissue. You can help improve the pain also. Verapamil is also used to treat high blood pressure.
  • The interferon. This medication appears to disrupt the fibrous tissue of the manufacturing. Interferon also appears to help break up the fibrous tissue down. Interferon has also been shown to relieve pain in the penis in patients with peyronie's disease.

Collagenase clostridium histolyticum (Xiaflex). This is the only FDA-approved medication for peyronie's disease. It is approved for use in adults with moderate-to-severe, and the curve of lumps under the skin that can feel.

This treatment has been shown to improve the curve and bothersome symptoms associated with peyronie's disease. The treatment works by breaking down the protein accumulation of collagen in the scar tissue causes the penis to curve. The collagenase seems to work best when used in conjunction with the traction therapy or other treatment is called a "model." With the modeling, a health professional will bend the penis in the opposite direction of the curve.

Ask your healthcare provider about the side effects of any medication you can take.

Traction therapy

The penile traction therapy involves stretching the penis with a mechanical device that you wear on a daily basis. You stretch your penis for a fixed amount of time to improve the length of the curve, and any other physical changes.

Depending on the device, the traction therapy may be necessary for as little as 30 minutes. Or it can be used as much as 3 to 8 hours a day. How well the treatment works may also depend on the specific device used.

Traction therapy is recommended in the early phase of peyronie's disease. It is the only treatment that have been shown to improve the length of the penis. Traction therapy can also be used in the chronic phase of the disease, in combination with other treatments or after surgery for a better result.

Surgery

Your doctor may suggest surgery if the curve or the curve of your penis is severe, it bothers you a lot or you are prevented from having sex. Most often, surgery is not recommended until you've had peyronie's disease for 9 to 12 months. It's also not recommended until the curve of your penis stops for the worse, and remains the same for at least 3 to 6 months, and the pain goes away.

Most common types of surgery for disease of peyronie's disease include:

  • Suture the unaffected side.Several procedures can be used to straighten the penis by the restriction of the longest side without scar tissue. These techniques are referred to as suture or plicating. Often they are used only for the curves that are less severe. Many techniques plication can be used. More often, they have similar rates of success. But the success of the surgery also depends on the surgeon's experience and preference.
  • Incision or excision and grafting.With this type of surgery, the surgeon makes one or more incisions in the tissue of the scar. This allows the cover to extend and straighten the penis. The surgeon may remove some of the scar tissue. A piece of fabric called a graft is often sewn into place to cover the holes in the tunica albuginea. The graft may be of tissue from your own body, human or animal tissue. Most of the times, this procedure is used to treat a severe curvature or other changes, such as dents on the penis.
  • Penile implants.A surgery is performed to place a device in the spongy tissue that fills with blood during an erection. You can get implants that can be folded down most of the time and the curve up to the sex. These are the so-called semi-rigid implants. More often, another type of implant is inflated with a pump implanted in the scrotum. Penile implants can be considered if you have disease of peyronie's disease and erectile dysfunction. When implants are placed in place, the surgeon may perform other procedures to improve the curvature of the penis, if it is necessary.

Suture the unaffected side. Several procedures can be used to straighten the penis by the restriction of the longest side without scar tissue. These techniques are referred to as suture or plicating. Often they are used only for the curves that are less severe.

Many techniques plication can be used. More often, they have similar rates of success. But the success of the surgery also depends on the surgeon's experience and preference.

Incision or excision and grafting. With this type of surgery, the surgeon makes one or more incisions in the tissue of the scar. This allows the cover to extend and straighten the penis. The surgeon may remove some of the scar tissue.

A piece of fabric called a graft is often sewn into place to cover the holes in the tunica albuginea. The graft may be of tissue from your own body, human or animal tissue.

Most of the times, this procedure is used to treat a severe curvature or other changes, such as dents on the penis.

Penile implants. A surgery is performed to place a device in the spongy tissue that fills with blood during an erection. You can get implants that can be folded down most of the time and the curve up to the sex. These are the so-called semi-rigid implants.

More often, another type of implant is inflated with a pump implanted in the scrotum. Penile implants can be considered if you have disease of peyronie's disease and erectile dysfunction.

When implants are placed in place, the surgeon may perform other procedures to improve the curvature of the penis, if it is necessary.

The type of surgery used depends on your condition. Your health care team will probably take into account where in the penis of her scar tissue, the severity of your symptoms and other factors. If you are not circumcised, your health care professional may recommend circumcision during the surgery.

Depending on the type of surgery you have, you may be able to return home from the hospital the same day. Or you might need to spend the night. Your surgeon will let you know how long you should wait before going back to work. More often, it takes a few days of rest. After surgery for peyronie's disease, you'll have to wait 4 to 8 weeks prior to any sexual activity.

Before coming to the surgery for the disease of peyronie's disease, ask your surgeon about the risks. These may include:

  • Loss of sensitivity in the penis.
  • Erectile dysfunction.
  • More of a shortening of the penis.
  • Infection.
  • Rarely, the turn of a bend in the penis after the surgery.

Other treatments

A technique known as iontophoresis uses an electric current to deliver verapamil together with a steroid through the skin. Research has shown mixed results in the improvement of the curvature of the penis and erectile function.

Researchers continue to explore other treatments for peyronie's disease. The evidence is limited in the way that they work and what are their side effects may be. Examples include the use of intense sound waves to break up scar tissue, stem cells, platelet-rich plasma and radiation therapy. Today, these therapies are considered experimental.

Coping and support

Peyronie's disease can cause anxiety and create a tension between you and your sexual partner.

These tips can help you cope better with peyronie's disease:

  • Explain to your partner what is the disease and how it affects your ability to have sex.
  • Let your partner know how you feel about the appearance of their penis and their ability to have sex.
  • Talk with your partner about how the two of you can maintain sexual and physical closeness.
  • Talk with a mental health professional who is an expert in family relations and sexual matters.

Preparing for your appointment

If you have peyronie's disease the symptoms of the disease, is likely to start by seeing your family doctor or general practitioner. You may be referred to a specialist in male sexual disorders that are called a urologist. Encourage your partner to join you in the check-up.

Preparing for your appointment will help you make the best use of your time.

What you can do

Make a list ahead of time that you can share with your health care professional. Your list should include:

  • The symptoms that I had, including those that may not appear to be associated with peyronie's disease.
  • Key personal information, including any major stresses or recent life changes.
  • The medicines you take, including any vitamins or supplements.
  • The history of the injury to the penis.
  • The family history of peyronie's disease, if any.
  • Questions to ask your health care team.

You could ask some of the following questions:

  • What tests are needed?
  • What treatment do you recommend it?
  • You can know if my symptoms are likely to get worse or get better?
  • Are there brochures or other printed material that I can take my house? What sites do you recommend?

Feel free to ask any other questions that you think you during your appointment.

What to expect from your doctor

Your doctor or other members of your health care team are likely to ask you some questions. Be prepared to respond to them. That way, you can be have time to go through any of the points you want to discuss more. You can ask:

  • When did you first notice a curve in the penis or the scar tissue just below the skin of your penis?
  • It has the curve in the penis get worse with time?
  • Do you have pain during erection? If so, has worsened or improved with time?
  • Do you remember having a lesion on his penis?
  • How your symptoms limit your ability to have sex?

Your health care professional may also ask you to complete a survey, such as the International Index of Erectile Function. This helps to describe how the disease affects his ability to have sex.

Symptoms and treatment of peyronie's disease