Peyronie’s disease was diagnosed for the first time by F. de la Peyronie, a french surgeon, thus the name of the disease remained named after him.
Peyronie’s disease is a specific condition in which the penis curves up toward the belly. Usually this is a result of plaque which is forming within the soft tissue of the penis thus forcing it to curve at an angle. Curved penis usually looks shorter than it is in reality, what might be a problem for many men.
A certain degree of curvature of the penis is considered normal, as many men are born with this benign condition, commonly referred to as congenital curvature. The disease, may cause pain, hardened, big, cord-like lesions (scar tissue known as “plaques”), or abnormal curvature of the penis when erect. A urologist can diagnose the disease and suggest treatment, and it is best to seek out a urologist who specializes in Peyronie’s Disease, as the disease and its current treatments are not well understood by general practitioners or family doctors. Without treatment, about 12-13% of patients suffering from Peyronie’s disease will spontaneously improve over time, 40-50% will get worse and the rest will be relatively stable.
There is quite an amount of possible treatment procedures. Each one is significantly different from others, varying mostly in effectiveness of treatment. We will list the most common treatments with their pros and cons:
Vitamin E supplementation has been studied for decades, and some success has been reported in older trials, but those successes have not been reliably repeated in larger, newer studies. A combination of Vitamin E and colchicine has shown some promise in delaying progression of the condition.
Injections to plaques (scar tissue formed by the inflammation) with Verapamil may be effective in some patients. Use of iontophoresis with Verapamil and Dexamethasone, applied to the affected areas has been studied but a recent placebo controlled trial failed to show a significant improvement. There are no clinical trials listed in the NIH trial registry.
Surgery, such as the “Nesbit operation”, is considered a last resort and should only be performed by highly skilled urological surgeons knowledgeable in specialized corrective surgical techniques. A penile prosthesis may be appropriate in advanced cases. A European surgery called the Leriche technique, in which an 18 gauge needle is used to lacerate the plaque, has shown effectiveness at reducing curvature and returning sexual function.
Doctors are starting to look into less intrusive forms of therapy as an alternative to surgery, which is becoming increasingly unpopular amongst both doctors and patients. Due to the very intrusive nature of penile curvature correction surgery, and the arguably scarce results that it provides at a very high economical, emotional, and physical cost, patient insatisfaction post surgery is very high. Most patients were unhappy with the results of the intervention due mostly to the penile shortening that happens after the surgery. As the scar retracts, the penis is pulled deeper into the body, eventually resulting in penile shortening. This was recorded in nearly 100% of the cases studied.
Although there is no cure for Peyronie’s Disease or fibrotic disorders that are localized in different areas of the body (Fibrosis), several clinical studies such as the one mentioned above point to penis extenders as the best treatment to correct curvature, or at the very least to impede the curvature from getting worse. According to Doctor Gontero, the leading Doctor of the above mentioned study which was published in the Journal of Sexual Medicine in 2009, “Overall results were self-reported as “acceptable”, making this minimally invasive treatment modality a potential new treatment option in selected Peyronie’s Disease patients.”
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