Peyronie’s disease is a condition in men in which a plaque or scar tissue is formed inside the penis resulting in the bending or curving of the penis. It is more common in men over the age of 40 and is thought to be caused by injury to the penis or an autoimmune disease. The disease affects 5-7% of men worldwide.
The presence of scar tissue or plaque is prominent on the penis. It causes curving and bending of the penis during erection, making sexual activity difficult. In addition, this condition causes stress and anxiety in males. Therefore, diagnosing and treating the disease as early as possible is essential. Early diagnosis and treatment help reverse the condition and prevent the chances of worsening.
Diagnosis of Peyronie’s disease
Diagnosis of Peyronie’s disease
Diagnosis is crucial to rule out the condition of penile curvature. Therefore, this is assessed and diagnosed by a urologist, a specialist in sexual and urinary problems. Scar tissue or plaque is prominent that it can be diagnosed only by physical examination. Regardless other tests are also required to confirm the diagnosis. The procedure of diagnosis consists of the following:
- Physical assessment
- Medical and family history
- Ultrasound
- Other tests
Physical assessment
Physical examination is essential in diagnosing Peyronie’s disease or penile curvature. It includes the following:
- Palpation of the penis in the absence of erection. It is performed to identify the location and the size of scar tissue.
- Length measurement of the penis. Peyroni’es disease also causes shortening of the penis; therefore, assessing the length of the penis helps determine the changes.
Medical and family history
Medical history indicates any injury or disease leading to the penile curvature. The doctor may also ask questions about any medication that you’re taking. On the other hand, family history determines if heredity is the cause of the disease.
Ultrasound
It is the most common diagnostic test used to indicate penile abnormalities. In this, sound waves are used to create an image of the soft tissues of the penis. It shows the presence of scar tissue (plaque), blood flow to the penis, and other abnormalities.
Other Tests
To examine the penis during erection, a test is performed in which a drug is injected into the penis to make it stiff and erect. Then, the patient is asked to take an image and show it on the follow-up to indicate the presence of a scar.
Treatment of Peyronie’s disease
Treatment of Peyronie’s disease
Treatment of Peyronie’s disease depends on the stage (phase) and severity of the disease. However, even in some cases, the scar tissue goes away independently. As a result, approximately 13 out of 100 patients don’t require treatment.
- Instead of surgery, treating the condition with medications for the first 12 months is suggested.
- A person with small plaques that don’t significantly affect the shape and size of the penis has no pain and no problems with sexual activity doesn’t require treatment.
However, there are various choices for those who require treatment. These are:
- Medications
- Penile injections
- Traction therapy
- Iontophoresis
- Surgery
- Other treatments
Medications
Following are the various medications that are known to be effective in this disease.
- Xiaflex (Collagenase clostridium histolyticum)
- Tamoxifen
- Pentoxifylline
- L-arginine
- Oral vitamin E
- Tadalafil (Cialis)
- Potassium amino-benzoate (Potaba)
- Colchicine
- Carnitine
Penile Injections
In cases of early diagnosis, penile injections are recommended to prevent the condition from worsening. These are as follows:
- Collagenase injections
- Interferon injections
- Verapamil injections
Traction Therapy
It includes stretching the penis with the help of a mechanical device to maintain its average length and curvature of the penis.
Duration of traction
To get the desired results, it is suggested to apply the traction for 30 minutes every three to eight hours daily.
Iontophoresis
It is a technique by which a combination of verapamil and a steroid is injected into the body using an electric current.
Surgery
Surgery is recommended in the chronic stage when the deformation of the penis is severe and affects the sexual activity of the person. The following are the options for surgery.
- Suturing (plicating) the unaffected side
- Incision or excision and grafting
- Penile prosthetic devices
Other Treatments
There are various other treatments for Peyronie’s disease, but a detailed study is still required to determine the benefits and side effects. Other treatments that are considered helpful in removing scar tissue are as follows:
- Shock wave therapy
- Stem cells
- Platelet-rich plasma
- Radiation therapy