Definition In individuals with Peyronie's disease, one or more small areas of fibrous tissue develop in the penis. The disease was first described by the French surgeon Francois de la Peyronie in 1743, though there are other reports dated a century earlier.
What is going on in the body? A firm, fibrous thickening develops on the upper (more common) or lower side of the penis. The fibrous areas (plaques) may be painless, but the ability of the penis to become erect can be affected. The penis may be curved when erect, with resulting pain.
What are the signs and symptoms of the disease?
pain during erection of the penis
lump in the penis that is felt when the penis is soft, and it is this area in which any discomfort with erections occurs
mild aching or uneasiness in a specific area of the penis well before any lump or plaque can be felt. As time goes on, the plaque may spread, causing more irregularity or bending of the penis, or discomfort
curve or bend in the erect penis
What are the causes and risks of the disease?
Sometimes, Peyronie's disease is due to infection or trauma, but usually the cause is unknown.
Peyronie's disease is most common in men in their forties to sixties, but can be seen as early as the twenties and thirties.
What can be done to prevent the disease? There is no known way to prevent Peyronie's disease.
How is the disease diagnosed? A healthcare professional performs a physical examination and asks the patient about symptoms that have developed before the examination.
What are the long-term effects of the disease? Peyronie's disease progresses slowly, if at all, and may resolve on its own.
What are the risks to others? Peyronie's disease is not contagious.
What are the treatments for the disease?
Because the cause of Peyronie's disease is still unknown, it is difficult to plan a treatment that works for everyone. There is no definite cure for Peyronie's disease. Peyronie's disease and all of its symptoms may lessen or disappear in some individuals.
If the bend is so severe that intercourse is impossible, or impotence has already developed, surgical treatment is probably the only reasonable option. The scarring plaque that causes the bend may need to be removed or cut to straighten the penis. This usually affects the quality of erections. A penile prosthesis may be required to obtain an erection that lasts long enough for penetration and normal sexual relations.
Medical therapies include vitamin E. Occasionally, these drugs will soften the plaque and relieve the symptoms. Vitamin E is safe and cheape and has no side effects. It is by far the most common initial treatment plan. Usually, the dose is 400 to 500 units two times a day. Failure to resolve the symptoms in 12 months usually means that this treatment will not be effective. Other medical therapies include colchieine, ultrasound of the penis and steroid injections into the plaque.
In patients who have significant discomfort, a drug that prevents inflammation, such as ibuprofen, can be used.
Other treatments depend on the extent of the disease and the number of symptoms. In certain cases, injections of steroids into the plaque may soften it, though this treatment can sometimes injure the tissue. Injections of collagenase, an enzyme that attacks the fibrous tissue, have also shown promise in dissolving the plaques.
What are the side effects of the treatments?
Surgery can result in infection, bleeding or pain.
Potaba can cause loss of appetite, nausea, fever or rash
Steroid injections can cause infection or ulceration at the site of the injection.
How is the disease monitored? Difficulty with intercourse and pain are the two most disabling complaints. Therefore, it may be helpful for an individual with the disease to keep a diary of the level of discomfort, dissatisfaction or improvement.
Author: Gary Kearney, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
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