Top 5 myths of Peyronie’s disease (PD)

Fact versus fiction

Like many other health disorders and disease, there have been several myths, misconceptions and false assumptions associated with Peyronie’s disease (PD). The following article intends to highlight some of those common myths related with PD and will help you differentiate between fact and fiction.

Myth 1: PD is a disease of young age

Fact: Greater than 75% of patients with PD are between 45 and 65 years of age. Similarly, some people also believe that Peyronie’s disease only affects men over 50 years of age. In reality, however, studies show that up to 10% of patients may present at age 40 and below.

Myth 2: PD is a disease of no known cause

Fact:  While it is true that no single established cause can be considered as the sole factor responsible in all cases of PD, trauma / injury to the penis is considered as one of the most common causes of PD. Similarly, Peyronie’s disease has also been linked to other generalized conditions such as hypertension and diabetes. Also, it has been also found to be associated with Dupuytren’s disease (palmar aponeurosis), Ledderhose’s disease (plantar aponeurosis), Paget’s disease and knuckle pads. The disease also tends to run in some families, from fathers to the sons.

Myth 3: PD leads to cancer

Fact: The plaque developed in PD itself is benign, or noncancerous (or non-malignant).  It is not a tumor and cannot spread to adjacent body parts of tissues. Similarly, Peyronie’s disease is not contagious (cannot be transmitted to one person to another by any means) and is not known to be caused by any transmittable disease.

Myth 4: Surgery is the single best option that can completely cure all the cases of PD

Fact: Surgery is one of the riskiest, expensive and complex treatment options and is almost always implied as the last resort when other treatments do not work. In addition, even successful surgeries cannot guarantee that the disease will not recur in the future. Also, not all surgeries have shown 100% resolution of symptoms and signs in PD.

Myth 5: There is no link between Peyronie’s disease and erectile dysfunction

Fact: While both conditions can occur independently, PD is associated with erectile dysfunction (or male impotency) in majority of its cases. As a result of more recent research, the correlation between Peyronie’s disease and erectile dysfunction is much clearer than previously recognized. Published studies and trials have indicated that as much as 30% to 80% of men may have erectile dysfunction associated with Peyronie’s disease.

How to identify if you have a Peyronie’s disease?

Signs & symptoms at a glance…

History and background

Generally speaking, Peyronie’s disease refers to the presence of scar tissue in the penis. The condition is so called as it was first described by a French surgeon Francois Peyronie about 250 years ago. Today, according to the generally accepted estimates, Peyronie’s affects millions of men usually beginning in their 50’s. The plaque forms from a lifetime of small injuries or tears.  These injuries heal by forming exaggerated plaques, which result in the Peyronie’s disease.  Men who form abnormal scar tissue elsewhere in the body are more susceptible to develop a Peyronie’s plaque.

How Peyronie’s disease develops?

The scar tissue, or Peyronie’s Plaque, forms in the wall of the tissue that surrounds the corpus cavernosum. That is, a plaque forms in the “canvas” (tunica albuginea) that wraps the erectile tissues. This plaque is a flat plate of scar tissue that actually develops on the top or bottom side of the penis inside a thick membrane called the

Signs & symptoms of Peyronie’s disease

The severity, progression and resolution of various signs and symptoms of Peyronie’s disease are variable and vary from person to person.  Symptoms may develop slowly or appear overnight.

In a follow-up study of 97 men, 40% reported a worsening of their signs and symptoms over time. However, in 47%, the disease had stabilized after resolution of the inflammatory process, and, in 13%, symptoms had even disappeared spontaneously.

As mentioned above, in Peyronie’s disease, a plaque or hard lump forms in the tissue of the penis. However, it is not 100% confirmed that what actually causes the disease. Some experts believe that it could be some hidden trauma or injury but it is not always confirmed.  The plaque makes the penis less flexible, causing pain and making the penis bend when it is erect. For the same reason, many men with Peyronie’s disease have sexual problems because they cannot get or maintain a normal erection. Patients also usually have increasingly painful erection and deviation of the penis. Similarly, in many other cases, these plaques can also cause pain with erection and curvature of the penis.  

In many men, the pain decreases over time, but the bend in the penis may remain a problem, making sexual intercourse difficult. The sexual problems that result can disrupt a couple’s physical and emotional relationship and can lower a man’s self-esteem.

Does Peyronie’s disease cause erectile dysfunction?

Unfortunately, yes, as Peyronie’s disease will not only cause abnormal shape / curvature of your penis but will also prevent blood flow beyond the plaque resulting in erectile dysfunction.  Correcting the plaque will improve potency. 

Can the signs & symptoms resolve on their own?

If you don’t get any treatment at all, spontaneous improvement is very rare.  However, after one year, about 2/3rd of the men do not get any worse and remain stable.  However, on the other hand, 1/3rd of men may have worsening of the signs & symptoms, eventually leading to potential complications.

Based on the above discussion and clinical features, it can be concluded that Peyronie’s disease is, in fact, a serious issue that can lead to severe deformity, abnormal shape, erectile dysfunction and many other sexual health problems in men. It is, therefore, crucial to address the problem as early as possible. As surgery and medical drug treatment options for Peyronie’s disease are not free from side effects and risks, you can always choose another option.

Treating Peyronie’s disease with surgery…

Why and why not?

Peyronie’s disease (PD) affects 1 to 3% of the male population and is considered one of the frequent causes of shortening of penis, penile shape deformities and erectile dysfunction. The treatment of PD, to date, remains one of the greatest therapy challenges for doctors and sexual health care experts. While various treatment options like radiotherapy, medical drug treatment (both oral medicines and injections) are available, surgery is often used to correct the curvature and shape of the penis.

The following article gives you an outline of different surgical procedures used to treat PD and also highlights different pros and cons of surgical treatment of the same.

Types of surgery for Peyronie’s disease

According to surveys and studies, three surgical procedures for Peyronie’s disease have had some success.

1-    Removal / cutting: The first procedure involves removing or cutting of the plaque and attaching a patch of skin, vein, or material made from animal organs. This method may straighten the penis and restore some lost length from Peyronie’s disease. However, some patients may experience numbness of the penis and loss of erectile function.

2-    Plication: A second procedure, called plication, involves removing or pinching a piece of the tunica albuginea from the side of the penis opposite the plaque, which cancels out the bending effect. This method is less likely to cause numbness or erectile dysfunction, but it cannot restore length or girth of the penis.

3-    Implant: A third surgical option is to implant a device that increases rigidity of the penis. In some cases, an implant alone will straighten the penis adequately. If the implant alone does not straighten the penis, implantation is combined with one of the other two surgical procedures.

In short, most of the time, these types of surgery can produce positive results. But because complications can occur, and because many of the effects of Peyronie’s disease (for example, shortening of the penis) are not usually corrected by surgery, most doctors prefer to perform surgery only on the small number of men with curvature severe enough to prevent sexual intercourse. One should also not forget the high costs associated with hospitalization and post-surgery expenses. Also, some common complications associated with penis surgery include bleeding, infection, permanent shortening or disability of penis and post-operative (after the surgery) pain.

Penis stretchers or extenders, on the other hand, are now being considered as one of the alternatives for Peyronie’s disease. A typical external penis stretching device, like that of SizeGenetics, works by allowing the patient to stretch the flaccid penis for several hours a day. The level of traction can be adjusted by adding metal sections to the length of the splint. Over time, the stretching action appears to either elongate the plaque, or cause remodeling of the tissue that has been damaged or abnormally thickened as a result of Peyronie’s disease.

Peyronie’s disease - Care & cure

A review of various treatment options

History & background of Peyronie’s disease

Peyronie’s disease accounts for 0.3 to 0.7% of all urinary system related disorders and it occurs most often in the fourth to sixth decades of life, and occasionally in men less than 20 year old. A small number of men with Peyronie’s disease will get better without treatment but drug therapy or radiation are normally used. Most of the medical and surgical treatments, however, are designed to improve the symptoms of the disease rather than to cure it. The following article is a short review of all the major treatment options that are currently being used to treat or cure Peyronie’s disease.

Medical drug treatment

Medical drug treatment of Peyronie’s disease can be of two types:

Oral therapy: Oral medication therapy is only effective in the early, or the acute phase of Peyronie’s. Thus, within the first year of developing a plaque, drugs like PABA, vitamin E and colchicine are considered as effective first line treatments.  However, after one year with a plaque, oral medications are rarely helpful. 

Injection therapy: If the condition is not improved by oral drug treatment, doctors may prescribe intralesional injections with Verapamil, interferons or steroids.  The penis is anesthetized initially and then the medication is injected into several sites within the Peyronie’s Plaque.  Following a series of 6 injections spaced at least every other week, 2/3 of men have improvement in their curvature, and 80% have improved erections. Verapamil and interferon alpha-2b seem to diminish curvature of the penis. On the other hands, these drugs are not free of some serious side effects.  Steroids, such as cortisone, have frequently produced unwanted side effects, such as the atrophy or death of healthy tissues.

Surgery: If injections fail, surgical removal of the plaque and reconstruction can be performed.  While surgery is successful at correcting the curvature of penis, it rarely improves the erectile dysfunction and is also risky (because of high risk of associated complications) and costly (very expensive).

Extracorporeal Shock Wave Therapy

Extracorporeal shockwave therapy (ESWT) uses vibrations caused by sound waves to treat the affected tissue. The sound waves come from a device applied to the outside of the body that generates short bursts of sound, called ‘sonic pulses’. The plaques on the penis are targeted, normally using ultrasound as a guide. 

Radiotherapy

Radiation therapy, in which high-energy rays are aimed at the plaque, has also been used. Like some of the chemical treatments, radiation appears to reduce pain, but it has no effect on the plaque itself and can cause unwelcome side effects such as erectile dysfunction.

The key question in the treatment of Peyronie’s disease probably is can we prevent disease progression resulting in penile shortening and curvature without surgery? None of the currently available treatment modalities so far has so demonstrated this effect conclusively. Use of traction based extenders or penis stretchers (e.g. SizeGenetics), however, does offer an attractive, economical, safe and natural option that has been found to have a role in correcting and preventing the abnormal curvature of the penis in many men.