OVERVIEW
Peyronie’s disease is a condition by which a small scar forms in the lining of the penis resulting in penile curvature, indentation or pain.
Symptoms
During the first 12 months you may experience pain with erections, curvature of the penis, an abnormal shape to the penis or a lump in the penis. Over the course of the first 12 months, the condition tends to stabilize with improvement in pain and stability of the curve.
Causes
Peyronie’s disease typically forms from microscopic trauma occurring during intercourse. The trauma leads to inflammation and then a penile scar or lump.
Diagnosis/Evaluation
- What to know before your visit:
- During your visit, your doctor will ask you questions regarding your medical history, surgical history, when the curvature was first identified, if the curvature impacts your ability to have intercourse and about the quality of your erections.
- A digital picture of your erect penis is often helpful to assess the curve in a more natural setting. Taking the picture from multiple angles is often helpful. Of note there are several phone applications that are available to password protect these photos.
- Tests that may be performed during or after your visit:
- Curve assessment: Your provider may inject a medication into the side of the penis to elicit an erection in the office. The provider will then measure the degree of penile curvature.
- Imaging: An ultrasound of the penis may be performed in follow-up to determine the degree of curvature and if erectile dysfunction is present.
Treatment
- Active phase (First 12-18 months):
- Ibuprofen may be utilized for pain control
- While there are various oral medications that may be used during the active phase of disease, none have been proven to work consistently in high level studies.
- Penile Traction device: A device that is placed on the penis 60 minutes per day to stretch the penis and mechanically break down the plaque.
- Stable phase (Typically after 12-18 months) – Non-Surgical
- Intralesional collagenase (Xiaflex®): A minimally invasive medication that is injected into the penile plaque to preferentially break-down the penile scar.
- Stable phase (Typically after 12-18 months) - Surgical
- Penile plication: A minimally invasive surgery that involves straightening the penis by “cinching” the penis on the side opposite the curve.
- Plaque excision and grafting: A surgical procedure that straightens the penis by removing the plaque and replacing it with a more pliable grafted material. Useful for the most severe curves or deformities.
- Penile implant: A surgical procedure involving the placement of cylinders/implant into your penis, a pump in your scrotum and a reservoir of fluid in your abdomen.
Schedule an appointment with a MidLantic Urology physician near you today!