Peyronie's disease

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Peyronie's disease
Curved and bent penis due to Peyronie's disease
Synonyms	Induratio penis plastica
Pronounce	N/A
Specialty	N/A
Symptoms	Penile pain, penile curvature, erectile dysfunction
Complications	Erectile dysfunction, emotional distress
Onset	Typically between 40 and 60 years of age
Duration	Can be chronic
Types	N/A
Causes	Connective tissue disorder, trauma
Risks	Genetic predisposition, age, diabetes, smoking
Diagnosis	Physical examination, ultrasound
Differential diagnosis	Penile fracture, urethral stricture
Prevention	N/A
Treatment	Medication, surgery, shockwave therapy
Medication	Collagenase clostridium histolyticum, verapamil, interferon
Prognosis	N/A
Frequency	Affects about 1% to 23% of men
Deaths	N/A

Peyronie's disease is a connective tissue disorder involving the growth of fibrous plaques in the soft tissue of the penis, leading to abnormal curvature during erection.

Pathophysiology

Peyronie's disease results from fibrotic changes within the tunica albuginea, the connective tissue envelope of the erectile tissue of the penis. This fibrosis leads to penile curvature and sometimes pain during erections. The underlying cause is not fully understood, but it is thought to be related to trauma, genetic factors, and possibly certain health conditions such as Dupuytren's contracture.

Symptoms

The primary symptom of Peyronie's disease is penile deformity, which typically manifests as a significant bend or curve during erection. Other symptoms may include pain during erection, erectile dysfunction, and a palpable lump in the penis. In some cases, the deformity may make sexual intercourse difficult or impossible.

Diagnosis

The diagnosis of Peyronie's disease is typically based on physical examination, patient history, and sometimes ultrasound imaging. During physical examination, the characteristic penile deformity can often be observed, and the plaques may be palpable. Ultrasound may be used to better visualize the plaques.

Treatment

Treatment for Peyronie's disease can be challenging and may include medical, non-surgical, and surgical options. Medical treatments include oral medications such as potassium para-aminobenzoate and colchicine, as well as injectable medications like verapamil and interferon injections. Non-surgical treatments include extracorporeal shock wave therapy (ESWT) and penile traction therapy. Surgical options are generally reserved for more severe cases and can involve plication procedures, plaque incision and grafting, or penile prosthesis implantation.

Epidemiology

Peyronie's disease primarily affects middle-aged and older men. Studies suggest that the prevalence of Peyronie's disease may be around 3-9% of men, but the true prevalence is likely to be higher due to underdiagnosis and underreporting.

Prognosis

The course of Peyronie's disease varies among individuals. Some men experience progression of their penile curvature, while others may see improvement or stabilization without treatment. Pain during erections generally improves over time. Treatment can help to reduce the curvature and improve sexual function, but it may not completely correct the deformity.

Prevention

There is no known way to prevent Peyronie's disease. However, avoiding penile injury (e.g., rough sexual practices or sports injuries) may reduce the risk. Maintaining good overall health and managing any underlying medical conditions can also help to maintain penile health.

Research

Ongoing research in Peyronie's disease includes studies to better understand the genetic and molecular mechanisms underlying the condition, as well as the development of new treatments.

See also

• Penis
• Erectile dysfunction
• Penile prosthesis

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References