What is Peyronie’s Disease?
Peyronie’s disease is a painful condition in which a man’s penis develops a curve—typically 45 degrees or greater–due to the accumulation of abnormal scar tissue or plaques inside the penis. Some experts suggest the condition develops when repeated mild trauma to the penis causes minor damage that accumulates over time. The trauma could be from sexual activity, sports injuries, or an accident. Damage causes scar tissue to develop, and the scars (lesions) decrease the ability of the penis to stretch and the organ leans toward the side of the scar. Peyronie’s disease can also develop in a small percentage of men who undergo radical prostatectomy. Other risk factors for Peyronie’s disease include diabetes, age, tobacco use, and presence of a connective tissue disease such as Dupuytren’s contracture, which is common in men with Peyronie’s disease.
According to the American Urological Association, up to 9 percent of men between the ages of 40 and 70 have some degree of Peyronie’s disease, although the number could be ever higher because men are too embarrassed to report it. It is much less common in younger men. (American Urological Association)
Peyronie’s disease can cause a significant amount of pain and some penile shortening, as well as prevent men from having sex because of the angle of the penis and/or the pain. Men with Peyronie’s disease often experience much anxiety and distress related to the disorder. Treatment typically is reserved for men who are experiencing pain, are unable to engage in sexual activities because of the curvature, and the curvature is worsening. In about 13 percent of men the condition disappears without treatment.
Treatments for Peyronie’s Disease
Treatment options include use of oral drugs, which have not been well studied. Some of them include tamoxifen, colchicines, paraminobenozoate, pentoxifylline, and the natural supplement vitamin E. Use of penile injections also is not well studied, but they can reduce the curvature and pain. Multiple injections into the lesions are necessary over several months. The drugs used for injections include verapamil, collagenase, and interferon, all of which can disrupt the protein (collagen) that is key in the formation of the scar tissue. Surgery is an option if the curvature is severe or prevents sexual activity. Before surgery is performed, however, the curvature should be stable (not gotten any worse) for at least three months and other treatment options should have been explored.
Another treatment approach that uses shockwaves has been controversial. Shockwaves are used to treat and break up kidney stones, so numerous studies have looked at how effective this approach could be in breaking up the plaque in the penis. Extracorporeal shock wave therapy (ESWT) for Peyronie’s disease has yielded mixed results. A recent study published in June 2010 reported on 157 patients who received an average of 3.5 ESWT treatments. One-third of the patients achieved significant reduction in curvature, while more than 90 percent of the men reported good reduction in pain and 6 percent had complete pain relief. No significant difference was seen in sexual function. (Busetto)