Peyronie's Disease -
Curvature of the Penis
Curvature of the penis is an abnormal curve in the penis which
occurs during an erection of the penis. This may cause difficulties
with sexual penetration and pain associated with sexual intercourse.
Description of the causes and risk factors of Peyronie's Disease
In Peyronie's disease (curvature of the penis), fibrous tissue
develops on the tunica albuginea (the lining of the erectile bodies
of the penis). The cause of fibrosis is not known.
The condition occurs in about 388 of 100,000 men. The fibrous
tissue causes a bending to develop during erection that is painful
and can make sexual intercourse difficult or impossible. The condition
is relatively uncommon and affects males between 40 and 60 years
and older.
An association has been noted with Dupuytren's contracture, a
cord-like thickening across the palm of one or both palms causing
the 4th and 5th fingers to pull in toward the palm -- a fairly
common disorder of Caucasian males over 50 years of age. However,
only 1 to 2% of men with Dupuytren's contracture develop
curvature
of the penis.
Other risk factors have not been identified. Also, there is an
association with HLA B27 antigen cross-reactivity. A person with
HLA B27 antigen cross-reactivity has a particular type of immune
cell marker. This indicates that the condition may be inherited
genetically.
Symptoms of Peyronie's Disease
- Painful erection
- Observable curving in the penis with an erection
- Observable narrowing
of the diameter of the penis with an erection
- Thick band of hard
tissue within the penis
Physical examination is sufficient to diagnose Peyronie's disease.
The hard plaques can be felt with or without an erection of the
penis. However it may be necessary to use injectable medicines
to induce an erection
for proper evaluation of the penile curvature.
The patient may also provide pictures of the erect penis for evaluation
by the physician. Ultrasound of the penis may demonstrate the lesions
in the penis, but is not necessary.
Treating Peyronie's
Symptoms may be decreased
somewhat with radiation therapy or corticosteroid injections into
the fibrous band of tissue. Topical verapamil, an oral medication used for high blood pressure, has recently been
shown to improve the disease, and has been approved for use in
treating Peyronie's.
If medical therapy fails and intercourse is not possible secondary
to the curvature of the penis, surgery may be utilized to correct
the curvature. Surgery is reserved for severe cases where intercourse
is not possible due to the high risk of the surgery causing impotence.
Prognosis
The condition is typically progressive and leads to the inability
to have sexual intercourse. The disease is also associated with
development of impotence.
Complications
The condition may make sexual intercourse difficult, painful,
or impossible. Surgical correction may also lead to impotence.
Contacting your health care provider
Contact your health care provider
if symptoms indicating curvature of the penis occur, particularly
if penile erections are painful.
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