Peyronie's Disease

Any man can be born with a curvature of the penis, but that is not the same as having Peyronie’s disease. Known also as Chronic Inflammation of the Tunica Albuginea (CITA), Peyronie’s Disease is an acquired medical condition that affects the curvature of the penis and causes pain (usually at the time of erection). It may also cause or worsen erectile dysfunction, loss of girth and/or penile length, and abnormal indentation of the penis.

Peyronie’s disease is a connective tissue disorder that is characterized by the formation of dense, hardened scar tissue (also referred to as lumps or plaques) in the area of the penis known as the tunica albuginea, the (normally elastic) thick sheath that surrounds the erectile tissue. The condition was named after a surgeon to Louis XIV of France, Francois de la Peyronie, who first described treatment options for this disorder in 1743. The condition is usually progressive with more bending and angulation of the penis over time. In most cases, the body can heal itself, usually after a year or two after the first noticeable onset; in other cases, measures need to be taken to treat the condition.

Incidence

Peyronie’s disease is a common urological condition that affects millions of men and occurs most frequently among males between the ages of 45-60; however, it can also affect the young or the elderly. A report published in 1995 by the National Institute of Health revealed that Peyronie’s disease occurs in approximately 1% of men, predominantly those of Caucasian descent, and among those who have a family history of connective tissue disorders. Other factors that are believed to indicate susceptibility to the disorder include males with blood type A and men who take beta blockers.

Although Peyronie’s disease is relatively uncommon, there is a high likelihood that the prevalence of this disease is actually higher than reported. The two most likely culprits for this are: a failure to report deformation and/or pain in cases where symptoms are mild; and a man’s reluctance to seek medical attention where fear or embarrassment is a factor.

Effects on Sex

In addition to the physical effects caused by Peyronie’s disease, there is also a big psychological impact on the sufferer. Although in most cases men will continue to be able to have intercourse with their sexual partners, those who have the condition in its advanced stages find that sexual intimacy becomes difficult, or even impossible. It can create limits on the choice one has for comfortable sexual positions, and/or cause problems maintaining an erection without experiencing pain. Peyronie’s disease is disabling for the sufferer as well as his lover -particularly at the time of intercourse - and can cause sufferers to go through depression and/or sexual withdrawal from their partner.

Causes

The underlying cause of this disorder are not well understood, but it is believed that there is a possibility that the disease can run in families - though most cases do not appear to be hereditary. A sudden onset of symptoms may indicate trauma in the penis caused by injury, extremely intense sex, or an invasive penile medical procedure e.g. urethral catherization. A gradual onset may be an indication of a genetic link - caused by an inherited abnormality of the human leukocyte antigen B27.

Diagnosis

A urological specialist can diagnose and suggest a course of treatment for Peyronie’s disease, but it can easily be diagnosed by a general practitioner as well. If you decide to see a doctor because you suspect that you may have this condition, it is helpful to review your family medical history and bring in a photo of the penis in an erect state. Not only does this assist in finding an accurate diagnosis, it also becomes an important record of the condition as a helpful way to track a patient’s response to therapy.

Treatment

Treatment options are for this condition are fairly limited. The primary goal in therapy is to reduce pain and help patients maintain sexual function. In certain cases, education about the disease and reassurance of the facts are all that is often required. Treatment methods are:

• Watchful waiting - this is generally the most favorable option because there is a high likelihood that the condition may clear up on its own, usually within 1 to 2 years.
• Physical therapy - many more specialists are embracing these physical manipulation techniques but they are still in the formative stages of development. They are: self-administered stretching techniques, and; stretching devices known as penis extenders that exert gentle force on the hardened tissue.
• Penile curvature corrective surgery - most effective when pain is severe and persistent, but risks are high. In rarer instances, when long-term deformity limits intercourse or causes too much pain, surgery is recommended.
• Medication - currently, there is a wide variety of pharmaceutical options available; the results, however, are still mixed.
• Alternative treatments (those used in conjunction with conventional treatments) are naturopathy and proper nutrition.
• Supplements - two types are believed to have positive benefits: Bromelain (pineapple enzyme) helps to prevent deposits of fibrin, believed to be what causes the connective tissue to thicken, and; Gotu Kola (centella asiatica), which supports normal development and healing of connective tissue.

Final Thoughts

The likelihood of developing Peyronie’s disease is low and statistically there's a good chance the condition will correct itself, especially with proper medical supervision and healthy lifestyle habits. For those whose condition is more advanced, the good news is that there are treatment options available that can return men to their normal sexual functioning.

For more related material on this topic, refer to How to Straighten a Downward Curved Penis in our Advice section.