What is Peyronie’s disease?

Peyronie’s disease is scar-like tissue that develops in the penis which causes it to change shape.

This scar tissue is often referred to as a “plaque.” This scar tissue typically causes the penis to curve and may result in an indention called an “hour-glass defect.” It is very common for men to lose length in their penis as a result of Peyronie’s disease. This is because the scar tissue will not expand like a normal erectile tissue.

Peyronie’s disease can cause significant psychological distress.

What causes Peyronie’s disease?

The exact cause is usually unknown.

Occasionally men may recall an injury to the penis during sex which later results in curvature.

In most cases men notice a gradual curvature with no preceding incident that gets worse overtime along with a palpable plaque (scar tissue) deep within their penis.

How common is Peyronie’s disease?

The most recent studies suggest possibly up to 13% of men have Peyronie’s disease in some form or fashion. In other words, it is very common.

Are there treatment options?

Yes! There are several different types of treatment options for men with Peyronie’s Disease.

 

Oral Medications

Generally speaking, we do not recommend oral medications as most studies have shown little to no benefit.

The exception is for men still experiencing pain with erection. In this instance NSAIDS (anti-inflammatories) can be very helpful.

 

Penile injections

Verapamil injections are a less invasive treatment option. They are typically administered into the plaque after a numbing shot. The verapamil helps prevent the scar tissue from reforming and the goal is to slowly weaken the plaque through a series of injections. A typical series is 1 injection every 2 weeks for a total of 12 injections. (6 months of therapy). There are no sexual restrictions. Mild bruising and discomfort are common short term. Studies regarding the effectiveness of these injections is limited.

 

Xiaflex

This medication is the only FDA approved therapy for men with Peyronie’s Disease. It is a collagenase which helps to break down scar tissue or plaque.

Requirements: Men must have a curvature greater than 30 degrees and less than 90 degrees. They also need to have a palpable plaque for the physician to target for the injection.

It does have sexual restrictions. Men are asked to abstain from sex for 2 weeks once the patient begins a cycle. A cycle consists of 2 injection visits in one week. Most men need 4 cycles to see improvement. Each cycle is separated by a 6-week break. All together is also approximately 6 months of therapy. There is less than 1% risk of penile fracture. Requires insurance approval. Can take up to 6 weeks for approval in some cases.

 

 

Goal for all injection therapies:

Curvature improvement. These therapies are designed to be a less invasive approach for men who wish to try and avoid surgical therapies. They rarely make the penis completely straight again.

 

Penile Traction and Vacuum Erection Devices

These are devices that can typically be purchased without a prescription. They help to stretch the penis and hopefully improve curvature. They typically need to be worn for long periods of time to be effective. This may be difficult for some men.

These are typically employed with injection therapy.

 

Surgery

Plication

This is an outpatient procedure typically covered by insurance. It is usually reserved for men with good erectile function. It generally consists of a small incision on the shaft of the penis. Soft permanent stitches are placed on the healthy side of the penis opposite the curvature. This helps to straighten the erect penis by limiting tissue expansion on the healthy side opposite the curvature. This can result in the appearance of a shortened penis.

 

Grafting

This is a more complicated operation where the scar tissue or Peyronie’s plaque is removed. The defect is then replaced with a graft. This is also typically an outpatient procedure that is covered by insurance for men with good erectile function. Risk can include: recurrence of curvature, erectile dysfunction, and numbness.

 

Penile Prosthesis

This a procedure typically reserved for men with erectile dysfunction (ED) and Peyronie’s disease. It is also typically an outpatient procedure covered by insurance. This procedure helps to correct erectile dysfunction and Peyronie’s disease at the same time. The penile prosthesis is completely hidden. The patient will pump a bulb that is located in between the testicles to cause the penis to become erect. There is normally residual curvature present immediately after implant that will improve with time as patient uses the device. It feels natural and does not interfere with ejaculation or orgasm.

 

What will happen if I do nothing?

12% of men will see improvement without any therapy.

48% of see worsening of curvature and 40% will see curvature stabilization

 

What about assistance for men in need of emotional support?

Yes, sexual health counselors and online forums can be extremely helpful. There are also several online organizations to help men. The link below is recommended by the American Urological Association.

http://www.peyroniesassociation.org

CONTACT US

Request to be contacted for an appointment

Click Here