Category: Peyronie’s Disease

Peyronie’s disease occurs when plaque (fibrous scar tissue) builds up in the penis and causes it to curve during an erection. About six out of 100 men between 40-70 develop the condition; though rare, some men develop it while in their 30s. Symptoms can build up gradually or occur suddenly, but you’re more likely to have them if your blood sugar is high, if you smoke, or if a family member has the disease.

At the office of board-certified urologist and men’s sexual health physician Dr. William Brant in Salt Lake City, Utah, we’re quite familiar with Peyronie’s disease and its symptoms, and we understand that your self-confidence can take a real hit if you’re unable to perform in the bedroom. Because of this, Dr. Brant is committed to providing his patients with research-driven treatments to address both their medical condition and their self-esteem. Here’s what he wants you to know about the symptoms of this disease and your treatment options.

Causes and the 5 telltale signs of Peyronie’s disease

Medical researchers don’t fully understand the causes of Peyronie’s disease, but multiple factors seem to be involved. The primary one is repeated trauma to the penis. The trauma can come from a number of causes, including:

• Athletic injury or accident
• Pressure from partner’s pubic bone
• Vigorous sex

However, since there often doesn’t appear to be a specific trauma, doctors speculate that the condition may be linked to underlying health conditions.

If the condition can be linked to trauma, the problem begins during the healing process. Scar tissue develops within the penile tissue in a disorganized manner, causing the development of nodules. On both sides of the penis, there’s a sponge-like tube containing small blood vessels, and the tubes are encased by an elastic tissue sheath that stretches during an erection.

When you become aroused, blood flow increases in the tubes’ vessels, the penis expands, straightens, and finally stiffens into an erection. With Peyronie’s disease, however, the area containing the scar tissue isn’t able to stretch, and the penis curves as a result — the most prominent sign of the disorder. The five telltale symptoms of Peyronie’s disease include:

1. Penile curvature
2. Pain during erections and intercourse
3. Penile lumps
4. Erectile dysfunction
5. Soft erections (and inability to penetrate)

These symptoms are by no means all the ones you can experience. Peyronie’s disease can also lead to penile shortening and/or narrowing, an “hourglass” indentation, anxiety and stress over performance issues, and an inability to father children.

Treatment of Peyronie’s disease

Treatment choice depends on whether you’re in the acute or chronic phase of the disease. The acute phase occurs over the first two to four weeks, though it can last up to a year; it’s characterized by pain, changes in penis length, and variable curvature. The chronic phase occurs after 3-12 months, when symptoms become stable.

For the acute phase, treatments come in three categories:

1. Recommended: Penile traction to prevent loss of length and minimize curvature
2. Optional: Oral medication and injection therapies can reduce pain and curvature
3. Not recommended: Surgery, since the disease needs to stabilize

For severe cases and chronic Peyronie’s disease, surgery may be your best option. Dr. Brant offers the following procedures.

Plication

Dr. Brant inserts stitches on the longer side of your penis to pull it toward a more neutral position. This outpatient procedure takes only about an hour, but you’ll be out of work for a day. You can generally resume sexual intercourse within five weeks.

You should be aware, though, that it can’t correct either indentation or hourglass deformities.

Grafting

Dr. Brant makes either one or two incisions on the short side of your penis and places a graft (using a vein or other material) to match the long side. A lot of men opt for this procedure because, following surgery, your penis may be up to one inch longer, depending on curvature.

Grafting is done as an outpatient procedure and takes three to four hours. You’ll need to stay home for a few days afterward, and you can generally resume intercourse within about eight weeks.

Penile prosthesis

Dr. Brant places a prosthesis inside your penis to improve erections and straighten the organ. The procedure takes up to 90 minutes. You can usually return home afterward, though sometimes you require an overnight stay.

With a prosthesis, you’ll be out of work for one to four weeks. You can generally resume intercourse within five to six weeks.

If you suffer from Peyronie’s disease, know that you are far from alone. This condition, characterized by a bent erection, may not be readily discussed among men in the locker room or at the office, yet it affects six out of 100 males, most commonly between 40 and 70.

Peyronie’s disease can also make erections painful, render sexual intercourse difficult, lead to erectile dysfunction, and cause a shortening of the penis or other penile deformities such as narrowing, indentations, and an hourglass-like appearance. Of course, those are just the physical symptoms. The emotional toll is paramount, as well. Some men notice symptoms suddenly; for others, they may emerge gradually over time.

Urologist Dr. William Brant understands that this issue may be challenging to discuss, but as a specialist in sexual and erectile medicine, he has helped countless men recover from Peyronie’s disease and reclaim healthy sex lives. To start the conversation, he offers the following overview.

Why is my erection bent?

The causes of Peyronie’s disease aren’t entirely understood. Some researchers believe it is a genetic disorder, while others think it is an autoimmune disorder. Among the most common theories is the result of a previous injury that caused internal bleeding in the penis. Even if the injury wasn’t severe enough to have caused significant pain, scar tissue built up in the tissue as it healed. During an erection, when the penis stretches, the scar tissue doesn’t stretch with it, which results in the curvature.

Diagnosing Peyronie’s disease

A physical exam is often enough to identify scar tissue in the penis and diagnose Peyronie’s disease. An ultrasound might also be ordered. Before testing, you’ll likely receive an injection directly into the penis that causes it to become erect. Ultrasound tests use sound waves to produce images of soft tissues.

Treatment options

Treatment recommendations depend on how long you’ve had symptoms and severity. First-line approaches include:

• Medication
• Penile traction therapy to stretch the penis
• Vacuum devices

If your curvature is acute or prevents you from having sex, Dr. Brant may recommend one of the following surgical solutions.

Plication (suturing)

Stitches are placed along the longer side of your penis to pull it toward a more neutral position. This is an outpatient procedure that takes about an hour, but you’ll need to rest the remainder of the day. Sexual intercourse can typically be resumed within five weeks. This procedure, however, can’t correct either indentation or hourglass deformities.

Grafting

This surgery requires Dr. Brant to make one or more cuts in the scar tissue, allowing the sheath to stretch out and straighten the penis. He may also remove some of the scar tissue. A piece of tissue, called a graft, may be sewn into place to cover the tunica albuginea holes. This surgery, generally used in men with more-severe curvatures, is also an outpatient procedure. It takes three to four hours and requires several days rest afterward. Sexual intercourse can be resumed in about eight weeks.

Penile prosthesis

A prosthesis is surgically placed inside the penis to straighten it and improve erections. This procedure takes up to 90 minutes and requires about four weeks of downtime. Sexual intercourse can be resumed within five to six weeks.