Peyronie’s Disease

Peyronie’s Disease

What is Peyronie’s disease

Peryronie’s is an abnormal curvature of the penis that occurs during an erection. The disease is not a health threat, but it can sometimes cause pain with erection and/ or with intercourse, and interfere with a man’s ability to have sexual intercourse. 

What causes Peyronie’s disease?

Peyronie’s disease sometimes develops when a hard lump of fibrous tissue (plaque) forms within tissue (Tunica) that envelopes the erectile tissues of the penis. The cause of this disease is not well understood, but we believe it affects men who are, for unclear reasons, predisposed to abnormal and/or exaggerated scarring to even small tissue injuries The disease may result from trauma that causes bleeding within the penis, but that does not account for all cases. The condition tends to be more common in middle aged and older men, but it can also affect younger men. There is a heritable component as well, as men with a positive family history of Peyronie’s Disease are at slightly higher risk for developing symptoms in their lifetime.

What are the symptoms?

Abnormal curvature of the penis is the most obvious symptom, with or without pain in the penis during erection. Many men report noting a shortening of their penis. Erectile dysfunction is also commonly caused by Peyronie’s Disease, though erectile dysfunction by itself does not cause Peyronie’s Disease.

How is Peyronie’s diagnosed?

The condition is diagnosed by physical examination. Often a plaque can be felt when the penis is limp, and curvature becomes apparent when the penis is erect. Sometimes  ultrasound is used to pinpoint the location and size of the plaque(s), and to determine if these are calcified. When the plaque is associated with pain, at UCSF, we often prescribe use of a medication called Pentoxifylline, which serves to improve blood flow to the penis, and often, to varying degrees, helps to halt the growth and calcification of plaques .

How is it treated? 

Sometimes the condition will improve on its own. When the plaque is associated with pain, at UCSF, we often prescribe use of a medication called Pentoxifylline, which serves to improve blood flow to the penis, and often, to varying degrees, helps to halt the growth and calcification of plaques .

Oral vitamin E has been reported to help some patients, but their effectiveness has not been clinically tested in large studies. An injectable agent, collagenase, is undergoing clinical trials, and preliminary studies are promising. This drug is not yet approved for use in the USA.

Surgical correction to correct the curvature is also option, particularly when the curvature prevents a man from having intercourse. Penile straightening procedures developed at UCSF such as the 16-Dot Penile Plication procedure, straighten the penis while minimizing risk to the penile nerves that govern erection function. For men with erectile dysfunction that is sufficiently severe that even use of erection-enhancing medications precludes satisfactory intercourse (regardless of degree of curvature), then, surgical placement of an inflatable penile prosthesis is also an option, as the latter serves to both provide satisfactory erection and also straightens the penis.

 

  

Related Providers

• Associate Professor of Urology and Epidemiology & Biostatistics, • Chief of Urology, San Francisco General Hospital, • Director, UCSF Male Genitourinary Reconstruction and Trauma Surgery Fellowship, • Residency Program Associate Director
Professor and Vice Chair
 of Urology
Associate Professor and Director, Male Reproductive Health