Peyronie’s disease is where plaques (segments of flat scar tissue) form under the skin of the penisфтв cause the penis to bend.
Peyronie’s Disease (PD) causes the penis to become indented during erections. The plaques can often be felt through the skin and can be painful.
How does the penis normally work?
The main roles of the penis are to carry urine and sperm out of the body. There are 3 tubes inside the penis. One is called the urethra. It is hollow and carries urine from the bladder through the penis to the outside.
The other 2 tubes are called the corpora cavernosa. These are soft, spongy tubes that fill with blood to make the penis stiff during an erection.
The 3 tubes are wrapped together by a very tough fibrous sheath called the tunica albuginea. During sex, the stiffness of the penis makes it hard enough to push into a woman’s vagina. Then the urethra acts as a channel to carry semen into the vagina.
Peyronie’s disease plaques mostly (70% of the time) form on the top (or dorsal side) of the penis. The plaques make the tunica albuginea less flexible and may cause the penis to bend upwards when it stiffens.
When plaques form on the bottom or side of the penis, the bend will be downward or sideways. Some men have more than one plaque, which may cause complex curves.
Sometimes plaques form that go all the way around the penis. These plaques most often do not cause curving but may cause the shaft of the penis to narrow like the neck of a bottle.
This is sometimes called “bottle-necking” or “waisting”. In bad cases, the plaque may collect calcium and become very hard, almost like a bone. Men may also notice their penis has shrunk or gotten shorter.
Other signs that you may have Peyronie’s disease are:
- bent/curved penis;
- lumps in the penis;
- painful erections;
- soft erections;
- having trouble with sex because of a bent/curved penis.
Peyronie’s disease can make your quality of life worse. Over 75 out of 100 men with Peyronie’s disease are stressed and depressed because of it. Unfortunately, many men with Peyronie’s disease are embarrassed and choose to suffer in silence rather than get help.
How common is Peyronie’s disease?
Peyronie’s disease is thought to happen in about 4 out of 100 men between the ages of 40 and 70. It is rare in young men but has been seen in men in their 30s. The number of cases may be higher than the estimates because many men may be embarrassed and choose not to see their health care provider.
Peyronie’s disease is likely caused by minor injury to the penis. This type of damage is most often caused by vigorous sex (such as bending the penis during penetration or pressure from a partner’s pubic bone), though it can also be caused by sports or other accidents.
Injury to the tunica albuginea may result in scar tissue forming in the cells (fibrosis). This scar tissue then forms the plaque of Peyronie’s disease. Peyronie’s disease is the result of a problem in the way the body heals wounds.
Stages of Peyronie’s
Peyronie’s disease is often split into 2 stages: the acute phase and the chronic phase. During both phases, the bent/curved penis may cause problems with sex. You also may have ED.
Acute Phase: The acute phase usually lasts for 5 to 7 months but can last up to 18 months in rare cases. During this time, the plaques form in the penis, the bending/curving of the penis gets worse and you may feel pain when your penis gets hard.
Chronic Phase: The chronic phase is when the plaque stops growing and the penis doesn’t bend any further. If there was pain with erection during the acute phase, it often will have ended by this time.
Not all men who suffer mild trauma to the penis get Peyronie’s disease. For this reason, most researchers believe there must be genetic or environmental reasons Peyronie’s disease plaques form. Men with certain connective tissue disorders (such as Dupuytren’s contractures or tympanosclerosis) and men who have a close family member with Peyronie’s disease have a greater risk of getting it.
Certain health issues, such as high blood sugar, tobacco use, or past pelvic trauma, may also lead to wound healing problems and may help cause Peyronie’s disease.
A health care provider may be able to tell if you have Peyronie’s disease with only a physical exam. The hard plaques can most often be felt whether the penis is stiff or not.
To check how the penis curves, a health care provider may inject a drug into your penis to make it stiff and may take pictures to study. In some cases, dynamic ultrasound, which uses sound waves to get a picture of what is in your body, is used to see where the plaque is, check for calcium buildup, and show how the blood flows in your penis.
In very few cases (about 13 out of 100), Peyronie’s disease goes away without being treated. Most health care experts suggest treating the disease without surgery for the first 12 months after the disease is first noticed. Men with small plaques, not much curving of the penis, no pain, and no problems with sex may not need to be treated. If you need to be treated, there are many choices.
If you need some further advice concerning the treatment of your ED or PD, don’t hesitate to contact our experts here.