Peyronie’s Disease Treatment in Salt Lake City, UT
Peyronie’s disease, which affects about six out of 100 men between the ages of 40-70, causes an abnormal bend or curvature that can lead to pain when you have erections.
If you have Peyronie’s disease, board-certified urologist William Brant, MD, FACS, FECSM, in Salt Lake City, Utah, provides research-driven treatment solutions. Dr. Brant’s fellowship focused on medical and surgical treatments for penile disorders, including plastic and reconstructive issues in penile deformities and erectile dysfunction, as well as prosthetic surgeries for erectile dysfunction, and his clinical research focused largely on issues in Peyronie’s disease.
Dr. Brant is also a member of multiple medical organizations, including the American Urological Association, the Sexual Medicine Society, and the Society of Urologic Prosthetic Surgeons. He has authored over 100 works, including various chapters in 6 textbooks of Urology.
Find out more by booking an exam online or by calling the office at (801) 965-2767 to schedule your Peyronie’s disease appointment in Salt Lake City. Men from all across the intermountain west including Wyoming, Idaho, Colorado, and Utah are willing to travel to Salt Lake City to consult with Dr. Brant given his urologic expertise.
What is Peyronie’s disease?
Peyronie’s disease causes abnormal plaques to form under the skin in your penis. These flat scar-tissue segments pull your skin during erections, which leads to an uncomfortable bend or curve.
In most cases, Peyronie’s disease stems from an injury to your penis, which can occur during vigorous sexual intercourse. Your penis can also bend and become damaged during penetration due to pressure from your partner’s pubic bone. However, sports injuries and other types of accidents can also lead to penile damage and scar tissue formation.
While Peyronie’s disease affects men of all ages and many walks of life, it’s more likely to occur if you use tobacco, have high blood sugar, or have a family history of Peyronie’s disease.
When should I see a urologist for Peyronie’s disease?
Peyronie’s disease can negatively affect your sexual health and put a strain on your relationship with your partner due to performance issues. You should schedule a visit with William Brant, MD, FACS, FECSM, if you experience any of the following Peyronie’s disease-related issues:
- Difficulty with penetration because of penile curvature
- Pain during intercourse
- Lumps in your penis
- Erectile dysfunction
- Soft erections
About 75% of men who have Peyronie’s disease become depressed and stressed because of their condition. Many men are too embarrassed and choose to suffer from the condition, even though effective treatment solutions are available.
How does a urologist treat Peyronie’s disease?
The team specializes in the most up-to-date Peyronie’s disease treatment solutions. Conservative treatments, including medications and penile injections, may be helpful if you have acute Peyronie’s disease complications.
However, for severe cases and chronic Peyronie’s disease, you may need a surgical procedure. You can read about some of the most common Peyronie’s disease surgeries below.
Plication involves putting stitches on the longer side of your penis to pull your penis to the middle (a more neutral position). This outpatient procedure, which takes about an hour, requires you to be out of work for a day. You can typically resume sexual intercourse within five weeks.
You have a very small risk of nerve injury and impotence after plication. It’s also important for you to know that this procedure cannot correct indentation or hourglass penis deformities.
Grafting for Peyronie’s disease involves making an incision (sometimes two incisions) on the short side of your penis and placing a graft to match the long side. This graft is either a vein or other material. Many men opt for grafting because, after surgery, your penis may be up to one inch longer, depending on curvature.
A grafting procedure takes about three or four hours and is done as an outpatient procedure. Plan to stay home for a few days afterward. Usually, you can resume sexual intercourse within about eight weeks.
You should know that you do have a moderate risk of nerve injury and impotence after grafting, but the team goes over your risks based on your unique needs.
This procedure involves placing a prosthesis to improve erections and to straighten your penis. A penile prosthesis procedure takes up to 90 minutes, but you can usually return home afterward, although an overnight stay is sometimes necessary.
With a prosthesis, you have no risk of impotence and a small risk of nerve injury. However, you may need to be out of work for one to four weeks. You should be able to return to normal sexual activities within five to six weeks.
Brief description on the three operations for Peyronie’s disease performed by Dr. Brant
|Surgical Technique||Put stitches on the longer side of the penis to pull the penis to the middle||Placement of a prosthesis to help erection and straighten the penis||Making incision on the short side of the penis and place a graft (either vein or other material) to match the long side|
|Penile length||Same as the length when stretched in the flaccid state||1/2 to 1 inch longer than the stretched penile length (depends on the amount of curve)||About the same as stretched penile length|
|Risk of impotence after surgery||Very small||From 10 to 50%, depending on penile circulation||N/A|
|Risk of nerve injury||Very small||Moderate||Small|
|One hour||3-4 hours||1-1.5 hours|
|Anesthesia||General||General or epidural||General or epidural|
|Hospital stay||Not necessary||Not necessary||Outpatient/Overnight|
|Return to work||1 day||2-3 days||1-4 weeks|
|Resume sexual intercourse||5 weeks||8 weeks||5-6 weeks|
|Other considerations||Cannot correct indentation or hourglass deformity||Second incisionneeded in some cases||Severe penile shortening if the device gets infected (less than 1% in healthy patients)|
Schedule a Peyronie’s Disease Consultation with Urologist William Brant, MD
If you’re struggling with painful penile curvature, you might have Peyronie’s disease, and urologist William Brant, MD may be able to help. To schedule an appointment in Salt Lake City, give our office a call at (801) 965-2767 or request an appointment through our secure online form.
PD is a condition in which inflammation or scarring of the tough covering of the erectile portion of the penis leads to symptoms. It usually starts with inflammation and, over time, becomes scar and stabilizes. During this first, or inflammatory phase, patients may have pain (either just in the flaccid state or with erection), tenderness, a mass, curvature or other deformities. Often, men notice that the process evolves during this period. The deformity may get worse, for example. Men usually notice that the penis gets shorter and narrower, sometimes just at one part of the penis. This period lasts for a variable amount of time, ranging from months to years. Eventually, the disorder goes into the second, or stable phase. Usually the pain is gone (except sometimes during intercourse) and the deformity is stable.
No one knows the exact cause of PD. In general, we believe that it is an abnormal healing response. That is, there is an injury (sometimes very, very minor and usually not noticed by the patient) but the body acts abnormally and causes inflammation and scarring.
It occurs in 3.5% to 9% of men, depending on age.
Several items are crucial to making sure you get the right diagnosis and treatment.
In addition to the physical exam, the deformity needs to be examined and documented. The patient may take a photograph of the erection at home or we can give an injection in clinic to give an “artificial erection” that we can evaluate in clinic.
Additionally, an ultrasound (safe, quick, and painless) is very helpful to assess the penile tissue and direct treatment strategy, although this is usually not needed.
ED is VERY common with Peyronie’s disease, at least 50% of men with PD have some ED also. Since the scarring affects the tissue surrounding the erection bodies (and often affects the erection bodies themselves), men often have arterial (“inflow”) and storage (“outflow”) problems.
In the early stages, the best treatments are medical, not surgical. There are many, many reported treatments for PD, most of which have no data whatsoever supporting them. However, men are often desperate and will try anything, even if it is unlikely to help. This is unfortunate because, while there is no perfect medical treatment for PD, there are certain strategies that are more likely to help than others.
The treatment strategy depends on many factors and needs to be individualized for each
patient. They may include pills, injections (a medication that goes directly into the affected area), and traction devices.
In the later stages, once the deformity is stable, treatment is usually surgical. A patient only needs surgical treatment if the deformity is enough that they cannot have intercourse (for example, if they have pain or their partner has pain) or if there is associated ED.
The actual surgical treatment depends on both the situation as well as patient goals. We have developed a chart [link to the Treatment Options sheet] that summarizes the different general surgical approaches.
Generally, surgical approaches include reconstructive and/or prosthetic surgery. The most popular reconstructive approach is to place permanent sutures in the penis on the opposite side of the curvature to straighten it out (“plication”). This approach has few risks but 1) this does not correct notches, waists, or other non-curvature deformities 2) this cannot correct any of the length/width loss that is often associated with PD.
Alternatively, the plaque/scar can be expanded and a patch can be placed (“grafting”). Although this can correct other deformities and may possibly reclaim some of the length/width loss, there are significant risks associated with this approach including worsening ED (up to 40%, depending on the patient) and further scarring. This should only be performed by a surgeon who has extensive experience in this type of reconstruction.
If the patient has ED associated with PD or if the patient develops ED (e.g. after a grafting procedure), usually the best approach is with a penile prosthesis. This usually corrects both the ED and the deformity at that same time. Occasionally, the prosthesis does not fully correct the deformity and additional procedures must be done, such as plication or grafting.