Peyronie Disease: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

In Peyronie disease, fibrous scar tissue forms in the deeper tissues under the skin of the penis. This leads to erections that are uncomfortable and curved. It may also cause the penis to shorten when erect. Peyronie's disease is not brought on by cancer.

Penises vary in shape and size. Thus, having a curved erection isn't always cause for alarm. Nonetheless, significant discomfort or bending is experienced by certain individuals with Peyronie disease.

This could prevent you from engaging in sexual activity. On the other hand, it can result in erectile dysfunction, which is the incapacity to get or keep an erection. Peyronie's illness often leaves its victims feeling anxious and stressed.

Peyronie's disease rarely goes away on its own. In the early stages, the majority of affected persons will either notice no change in their condition or a slight worsening. Following a diagnosis, and receiving treatment as soon as feasible may help symptoms or stop the condition from getting worse. Even if you've had Peyronie disease for a while, treatment may help lessen symptoms including discomfort, curvature, and shortening.

Causes Of Peyronie Disease

What specifically causes Peyronie's disease is unknown. However, it seems that several factors are involved. It is thought that the primary cause of Peyronie disease is repeated trauma to the penis during sexual activity. However, the penis can also get injured through exercise or accidents.

 Many people who suffer from Peyronie disease are unable to pinpoint the exact injury that started their symptoms. During the healing process, scar tissue develops from a penile injury. Penile curvature or a palpable lump could be the outcome of this.

On either side of the penis lies a tube called the corpus cavernosum, which looks like a sponge. These tubes are filled with countless tiny blood vessels. Encircling every corpora cavernosa is an elastic tissue sheath called the tunica albuginea. 

When you are sexually excited, more blood rushes to these chambers. As the chambers fill with blood, the penis grows, straightens, and stiffens into an erection. In Peyronie disease, the scarred area does not grow as the penis erects. As a result, the penis bends or goes through various changes. This could be harmful to try.

Most people with Peyronie disease have gradually developed symptoms that don't seem to be connected to trauma. Researchers are looking at the idea that certain medical conditions or a genetic predisposition could be linked to Peyronie disease.

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Symptoms Of Peyronie Disease

Peyronie's sickness could present with progressive symptoms or sudden onset. Some of the most common symptoms are:

• Scarring of tissue: Another word for the scar tissue connected to Peyronie's disease is plaque. It's not the same as plaque, which builds up in blood vessels or on your teeth. Beneath the skin of the penis, it feels like a band of solid tissue or flat lumps. Tenderness above the scar tissue could exist.
• Bending of the penis: The penis can curve downward, upward, or to one side.
• Erection-related problems: An erection may be difficult to get or keep going if you have Peyronie disease. This is also known as erectile dysfunction. However, many Peyronie disease patients report that erectile dysfunction manifests itself before other penile symptoms do.
• Decrease in penis length: During erections, Peyronie disease may cause the penis to shorten.
• Penile pain: This symptom might manifest either during or after an erection.
• Additional changes to the structure of the penis: A narrow or indented erect penis may be present in some Peyronie's disease patients. With a tight, narrow band encircling the shaft, it can even have the appearance of an hourglass.
• Penile curvature and shortening associated with Peyronie disease may worsen with time: Physical alterations in the penis usually worsen or stay the same during the first year or year and a half.

Usually, erection pain subsides in a year or two. Scar tissue, curvature, and penile shortening usually do not go away. The pain and curvature associated with Peyronie's disease sometimes, however infrequently, resolve on their own without the need for medical attention.

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Risk Factors Of Peyronie Disease

It is rare for small penile injuries to lead to Peyronie disease. Peyronie disease may be associated with the buildup of scar tissue and insufficient wound healing. They include:

• History within the family: If you have a family member with Peyronie disease, your chances of getting the illness are higher.
• Conditions affecting the connective tissue: People with certain medical conditions that affect the body's connective tissue seem to be more vulnerable to Peyronie disease. The fingers of some Peyronie disease patients, for example, may draw inward due to a thick cord under the skin of the palm. We call this type of contracture Dupuytren's.
• Age: The effects of Peyronie disease can occur at any age. That does, however, grow increasingly common between 45 and 70 years old. In younger men, penile curvature is less commonly caused by Peyronie disease. Congenital penile curvature is a term that is more frequently used. A small amount of curvature is normal in younger guys and should not be alarming.
• Additional factors: There could be more factors connected to Peyronie's disease. These comprise smoking, particular illnesses, and particular types of prostate surgery.

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Diagnosis Of Peyronie Disease

For most medical professionals, a physical examination is all that is needed to diagnose Peyronie's disease. Tests may also be conducted to rule out conditions other than the one generating the symptoms.

You might need to take the following tests:

• Physical assessment: Your doctor will feel your penis to assess the amount and location of scar tissue if it is not erect. You can also measure the length of your penis. If the issue gets worse, this measurement can assist in determining whether the penis has gotten shorter.
• In addition, your doctor can want you to bring home photos of yourself with your penis erected. This can help determine the location of the scar tissue, its degree of curvature, and other details.
• Other evaluations: Your doctor may recommend an ultrasound or other tests to check your penis when it is erect. To help your penis grow erect before the test, you'll probably receive an injection directly into it. 
• Ultrasonography is the most widely used test for conditions affecting the penis: It uses sound waves to make images of the soft tissues in the body. Any aberrant signs, such as the presence of scar tissue and blood flow to the penis, can be found during these examinations.

The length of time that symptoms have been present determines the treatment plan for Peyronie's disease. It includes the following phases depending on the extent of symptoms:

• Acute phase: Scar tissue makes changes to the penis's length or curve worse. Having an erection might cause pain as well. The acute phase may last for up to 18 months.
• Chronic phase: As the formation of scar tissue in the penis stops, your symptoms will settle. Furthermore, there are no alterations to the dimensions, form, or other attributes of your penis. The chronic phase of Peyronie's disease comes later.

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Treatment for the acute stage of Peyronie disease

The following are the treatments for the acute stage of the illness:

• Traction therapy: Early on in the procedure, a device that holds the penis in a cradle and exerts stress may be helpful. We call this type of treatment penile traction. 
• Drugs: There are injectable and oral treatments available at this point. Several drugs that were previously recommended are useless. Some may or may not offer assistance. Your healthcare professional and you will most likely have a longer talk.
• Surgery is not recommended in cases of acute Peyronie disease: It is not a recommended course of action till the discomfort ceases and the issue doesn't get worse. This reduces the possibility of needing another surgery.

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Treatment for the chronic stage of Peyronie disease

In the chronic phase of the condition, treatment options include:

• During "watchful waiting," your healthcare team keeps a careful eye on your condition and treats you when needed.
• Injections or shots placed within the scar tissue.
• Stretching devices, also called "traction" therapy.
• surgery to straighten the penis.

These treatments can be used separately or in combination. Oral medication is not recommended during the chronic phase. As the condition progresses, they haven't shown any evidence of effectiveness.

Medications

Oral medicines have been used to treat Peyronie's disease. Studies have shown that many of them don't always work and are ineffectual when compared to other treatments.

If drugs are injected directly into the penile scar tissue, some people may have reduced pain and curvature related to Peyronie disease. Depending on the therapy plan, you can receive topical medicine, sometimes referred to as a local anesthetic, to make the injections less painful for you.

If you are receiving one of these therapies, you will likely receive several doses over several months. Moreover, injectable treatments may be coupled with oral drugs and traction therapy.

Medications that can be injected include:

• Collagenase from Clostridium histolyticum: This is the only Peyronie disease medicine that has been approved by the FDA. It can be used by adults who have palpable lumps beneath the skin and moderate to severe curvature. Its treatment has been shown to lessen the uncomfortable and curved symptoms of Peyronie disease. The treatment works by breaking down the buildup of collagen proteins in the scar tissue that causes the penis to bend. Collagenase seems to work best in conjunction with traction therapy or another type of treatment referred to as "modeling." To demonstrate, a doctor will bend the penis in the opposite direction of the curve.
• Verapamil: It appears that this drug works by disturbing pre-existing scar tissue and preventing the growth of new scar tissue. It may also reduce discomfort. Moreover, verapamil is utilized to treat high blood pressure.
• Interferon: It seems that this drug prevents fibrous tissue from forming. It seems that interferon contributes to the degradation of fibrous tissue as well. Interferon has also been shown to help people with Peyronie disease with their penile pain. Ask your doctor about the possible side effects of any medications you are currently taking.

Traction therapy

Penile traction therapy involves daily use of a mechanical device to enlarge the penis. You extend your penis to emphasize its length, curve, and other physical attributes for a set amount of time.

Some traction therapy devices may only need to be used for 30 minutes at a time. Alternatively, it may require wearing for up to three or eight hours per day. The specific device used could potentially affect the efficacy of the treatment.

Traction therapy is recommended in the early stages of Peyronie's disease. The only drug that has been shown to extend the penis is this one. Traction therapy can also be used following surgery or in combination with other treatments throughout the chronic phase of the illness for optimal outcomes.

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Complications Of Peyronie Disease

Follow-up issues could result from Peyronie disease:

• Unable to engage in sexual activity.
• Having trouble getting or keeping an erection is known as erectile dysfunction.
• Sorrow, stress, or worry about your penis's look or your inability to have sex.
• Focus on the relationship you have with your sexual partner.
• Difficulties getting pregnant because having sex is hard or impossible.
• Reduction in penis length.
• Penile pain.

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