Peyronie’s disease is also called as induratio penis plastica, or lately, chronic inflammation of tunica albuginea. It is a disorder of the connective tissue of the penis, in which fibrous scar tissue develops inside it, making for curved and painful erections. It affects up to nearly 10% of all men. The cause is yet to be understood, though injury or trauma to the penis, say during sexual or athletic activity, is thought to be responsible. Genetic predisposition is also thought to play a role.
Those affected might be able to feel the bands or lumps of hard scar tissue beneath the skin of their penis. The penis will be curved or bent, and may be short. You may have difficulty in having an erection. There can be pain during erection, orgasm or even on touching the penis. You should consult a doctor if you are having anxiety, pain or difficulty in having sex.
Various Options For Peyronie’s Treatment
Your doctor might recommend a wait-and-watch approach if your penis is less curved, you are not having pain during sex, and erections are causing only mild pain. However, if the symptoms are worsening with time or are severe, you will need medications and sometimes even surgery.
Medications are not as effective as surgery, and their use in Peyronie’s disease is controversial according to some. The medications can be given orally or injected directly into penis. Medications used are the following.
This drug is normally used in treating high blood pressure. Verapamil helps in Peyronie’s disease because it disrupts the production of the scar tissue or collagen. Cream of verapamil can also be applied topically if you do not want to take penile injections.
Interferon helps by interfering with scar tissue or fibrous tissue formation. It also breaks down the fibrous tissue already formed.
This is an enzyme which is still under investigation for treating Peyronie’s disease. It works by breaking down the fibrous scar tissue.
Vitamin E supplements, particularly in combination with colchicine, are thought to halt the progression of Peyronie’s disease.
Some drugs that act through modulation of inflammation are para-aminobenzoate, coenzyme Q10, and pentoxyfilline. Newer agents being tried include sildenafil, L-arginine, and L-carnitine.
Surgery is necessary in severe cases. But it is undertaken only after curvature of the penis has stabilized and you have been having painless erections for the past six months. Common surgical options are the following.
Shortening of Unaffected Side
Nesbit plication is a type of this procedure. This surgery basically involves shortening the normal, longer side of penis (the one without the scar tissue), so that both sides are of roughly equal length on erection. Since this decreases the total length of penis, it should be undertaken only in those with adequate length of penis and in whom the curvature is less severe. One of the complications of this procedure may be impotence.
Spongy tissue of penis may be replaced by semi-rigid penile implants. This is usually accompanied by the making of incisions in the fibrous scar tissue. This procedure is particularly helpful when there is also impotence in addition to Peyronie’s disease.
Following surgery, sometimes you may need to stay in the hospital overnight. While you may go back to work in a few days, you should avoid intercourse for 4-8 weeks after surgery.
Lengthening of Affected Side
On the side with scar tissue, several cuts are made in that scar tissue, facilitating the stretching of penile sheath and straightening of the penis. Some scar tissue may need to be removed, and tissue grafts are inserted in its place. Impotence is a greater risk with this procedure.
There are several other treatments under investigation. They include shock wave therapy, radiation therapy, and devices for stretching the penis.
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