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Peyronie’s Disease

Last updated March 21, 2018

Approved by: Krish Tangella MD, MBA, FCAP

Peyronie’s Disease is a connective tissue disorder characterized by the growth of fibrous tissue/plaque in the soft tissues of the penis, affecting middle-aged and elderly men.


What are the other Names for this Condition? (Also known as/Synonyms)

  • Chronic Inflammation of the Tunica Albuginea (CITA)
  • CITA (Chronic Inflammation of the Tunica Albuginea)
  • Plastic Induration of Penis

What is Peyronie’s Disease? (Definition/Background Information)

  • Peyronie’s Disease is a connective tissue disorder characterized by the growth of fibrous tissue/plaque in the soft tissues of the penis, affecting middle-aged and elderly men
  • It is an inflammatory process that occurs in the tunica albuginea, which is a thick sheath of tissue covering the corpora cavernosa. The corpora cavernosa is a pair of sponge-like tissue in the penis that help in erection
  • Peyronie’s Disease results in pain and abnormal bending of the penis, which makes it difficult for a man to have sex and maintain an erection. It usually affects the upper side of the penis, but very rarely, it may affect the lower side or both lower and upper sides too
  • The several possible causes of the condition includes trauma or injury to the penis during sexual activity, sports injury and accidents, use of anti-hypertensive drugs (calcium channel blockers), and the use of beta blocker drugs
  • Peyronie’s Disease can lead to the formation of scar tissue that can be felt under the penis and bending of the penis. The possible complications of the disorder are erectile dysfunction and an inability to perform sexual intercourse
  • A wait and watch approach may be followed by the physician, when the bending of the penis is not severe. Medications and surgery may be needed only when the condition is severe and/or worsens with time

Who gets Peyronie’s Disease? (Age and Sex Distribution)

  • Peyronie’s Disease affects men in the age group of 30-80 years
  • The condition is seen worldwide; all racial groups and ethnicities may be affected

What are the Risk Factors for Peyronie’s Disease? (Predisposing Factors)

The following are the risk factors associated with Peyronie’s disease are:

  • Age: Middle-aged and older men belonging to the age group of 30 to 80 years are more at risk. Also, the risk for Peyronie’s Disease increases with increase in age
  • Hereditary factors: Having a blood-related (immediate) family member, such as a father or brother, increases the risk
  • Presence of connective tissue disorders
  • Prostate surgery: Any individual who has undergone prostate surgery is likely to develop Peyronie’s Disease
  • Smoking: Smoking habit is likely to increase the risk for Peyronie’s Disease

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Peyronie’s Disease? (Etiology)

The various possible causes for Peyronie’s Disease development include:

  • Trauma or injury to the penis during sexual activity, sports, and accidents
  • Use of anti-hypertensive drugs called calcium channel blockers
  • Use of all beta blocker drugs
  • Rupture of small blood vessels inside the penis, due to a variety of causes

What are the Signs and Symptoms of Peyronie’s Disease?

The most common signs and symptoms of Peyronie’s disease include:

  • Scar tissue: Flat lumps/stretches of band tissues can be felt under the penis
  • Bending of the penis: The penis may appear to be curved upward, downward, or onto one side
  • Erection problems: The bending of the penis will lead to problems in erection
  • Shortening of the penis: Peyronie’s Disease will result in the penis becoming shorter
  • Pain: Pain may be experienced during erection

How is Peyronie’s Disease Diagnosed?

A physical exam of the penis is usually sufficient to make the diagnosis. However, the diagnosis of Peyronie’s Disease may involve:

  • Complete evaluation of one’s medical history along with a thorough physical exam
  • The physician will examine the penis to determine the location and extent of scar tissue present

Other tests required to be performed will include:

  • Ultrasound scan of the penis
  • X-ray of the penis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Peyronie’s Disease?

The complications associated with Peyronie’s Disease could include:

  • Erectile dysfunction: Difficulty in achieving and maintaining an erection
  • Inability to perform sexual intercourse
  • Infertility
  • Cosmetic disfigurement of the penis
  • Psychological stress due to problems associated with sexual relationship(s)

How is Peyronie’s Disease Treated?

The physician may employ a wait and watch approach, when the bending or curvature of the penis is not severe, and if no pain is experienced during erections. Medications (including oral and topical applications) and surgery for Peyronie’s Disease is necessary, only when the condition gets severe or worsens with time.

Medications:

  • Common medications used include:
    • Verapamil: It is used to treat high blood pressure; it helps in reducing the production of collagen
    • Interferon: It helps in reducing the production of fibrous tissue
    • Collagenase: It is an enzyme that is used to breakdown fibrous scar tissue. Currently, researches are being held to explore the use of this drug in treating Peyronie’s Disease
    • Collagenase clostridium histolyticum: It is an enzyme (medication) that is used to breakdown fibrous scar tissue and recommended for moderate-to-severe cases. It is an FDA-approved treatment measure for Peyronie’s Disease
  • In rare cases, drugs may be injected directly into the penis to reduce the bend

Surgery: When the disease becomes severe, surgery is recommended and various surgical procedures that may be adopted include:

  • Shortening the unaffected side:
    • The longer side of the penis is shortened so that it is equal to the affected side when erect
    • This is usually performed in men who have a lengthy penis and the curvature of the penis is less severe
  • Lengthening of the affected side:
    • Several cuts are made on the scar tissue, so that the sheath stretches out and the penis becomes straight
    • This procedure is usually performed on men who have short penis and severe disease condition
  • Penile implant: Penile implants are surgical implants to replace the spongy tissue that fills with blood during an erection

Other treatment procedures for this penile deformity include the use low-dose radiation therapy. It may be used during the early stages of the disease to break-up scar tissue and stretch the penis (correct curvature of penis) for enhanced sexual functioning.

How can Peyronie’s Disease be Prevented?

Peyronie’s Disease may be prevented by using the following measures such as:

  • Avoiding injury or trauma to the penis
  • Avoiding the use of beta blockers and anti-hypertensive drugs, unless really necessary and when prescribed by the physician
  • Avoid smoking

What is the Prognosis of Peyronie’s Disease?

  • Peyronie’s Disease is a self-limiting condition in a small percentage of men. However in others, the condition may progressively worsen or remain stable
  • With proper treatment most men with Peyronie’s Disease can have fairly normal sexual functioning including intercourse

Additional and Relevant Useful Information for Peyronie’s Disease:

  • In a penile implant procedure, a medical device is inserted within the penis to allow men who have erectile dysfunction, to develop an erection

The following article link will help you understand the penile implant surgical procedure:

http://www.dovemed.com/common-procedures/procedures-surgical/penile-implant/

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Helpful Peer-Reviewed Medical Articles:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: May 27, 2015
Last updated: March 21, 2018