Peyronie’s disease is one of the important diseases that cause erectile dysfunction in the penis. Although it is seen in different age groups, it is more common in middle and advanced age groups during sexually active age periods.
A structural disorder and an anatomical defect occur in the penis. It is a disease that is mostly seen together with hard palpable plaques on the penile tunica and then curvatures in the penis.
This article includes explanations to frequently asked questions about Peyronie’s disease. The topics in the article consist of questions that are frequently asked to us.
What is Peyronie’s (penile curvature) disease?
Peyronie’s disease is a penile disease named after the famous French surgeon who first described it. It is a disease characterized by structural changes in the layer (tunica albuginea) surrounding the spongy tissues that provide erection in the penis.
As a result of this structural change, stiffness in the sheath surrounding the spongy tissue and deformities in the penis (penis curvature) are observed. Calcification on the sheath can also prevent the hardening of the penis.
What are the causes of Peyronie’s Disease?
- Microtraumas
The most common known factor for Peyronie’s Disease is microtrauma to the penis. Forcing the penis during sexual intercourse, bending and twisting of the penis during erection with an undesirable movement, and hard penile movements during intercourse constitute the basis of these microtraumas.
- Difficulties due to penile curvature
Peyronie’s disease can be seen in those with congenital or acquired penile curvature due to strain during intercourse. It also occurs after some long-term and repetitive positions during sexual intercourse.
- Systemic diseases
Among the systemic diseases, Peyronie’s disease is most frequently seen in Diabetes. Apart from this, Peyronie’s can be seen after other systemic diseases (such as hypertension, chronic kidney failure) and drugs used for these diseases. Alcohol and smoking are also among other disease factors.
What is plaque in Peyronie’s disease?
Small hard areas on the penis that occur during Peyronie’s Disease are called Peyronie’s plaques. Since these plaques mostly prevent the stretching and hardening of the penis, they cause palpable hardness in the penis and accordingly lead to various symptoms such as loss of erection, deformity, shortening of the penis length and penile curvature.
At what age does penile curvature disease occur?
Peyronie’s disease is frequently seen in the 40-60 age group. However, there are cases where the disease can resolve spontaneously without any treatment. Therefore, this disease can be seen at an earlier age or at a later age.
What is the process of Peyronie’s disease?
It progresses for 1 year from the first time the symptoms of the disease begin to appear. During this period, various oral medications are tried in the treatment. It is important to follow and control this 1-year process well. Mostly, no surgical intervention is planned before the completion of the 1-year period from the onset of the disease.
How is Peyronie’s disease diagnosed?
The diagnosis of Peyronie’s disease is made by the patient’s history and physical examination. Necessary laboratory and radiological results are requested if needed.
This group of patients has the following complaints:
- Palpable penile stiffness
- Pain in penis
- Penile erection disorder
- Shortening of the penis
- Curvature of the penis
- Difficulty in sexual intercourse
- Pain in the penis during sexual intercourse
By manual examination of the plaques described by the patient;
- Presence of plaque
- Number of plaques
- Plaque location
- Determination of plaque size
- In case of need, penile color Doppler ultrasonography is used.
In which department is curved penis disease treated?
In the Andrology department of Health Centers, doctors in the Urology department treat this disease. We carry out all kinds of diagnosis and treatment for Peyronie’s disease in our clinic located at Kale Office Plaza in Çukurambar, Ankara/Turkey.
How is Peyronie’s (curved penis) disease treated?
The period of onset of disease symptoms is very important in determining treatment options. Patient complaints are also taken into account. Especially in cases with pain, more care should be taken and treatment should be planned to reduce pain.
While treatment is done with drugs in the early stages of the disease, surgical treatment option emerges in the later stages of the disease, especially in cases that cause deformity in the penis (penile curvature).
In the first 1 year period when the symptoms of the disease begin, the disease is tried to be controlled mostly with oral drug treatments.
What are the drug treatments for Peyronie’s disease?
Oral medications:
Vitamin E, Colchicine, POT**BA and Nonsteroidal anti-inflammatory drugs are used.
Drugs injected into the Peyronie’s Plate:
With these drugs, it is aimed to dissolve the hardness. For this purpose, many different groups of drugs are used. There is a large amount of scientific literature about the drug called Ver**pamil and it is reported that a significant part of the patients have a dissolving effect on the plaque when it is squeezed into the plaque.
Recently, there are various reports that some dissolving drugs obtained from the toxin of the microorganism called Clostridium Difficile are also effective.
What is the surgical treatment of Peyronie’s disease?
Surgery to correct the curvature of the penis:
Many surgical techniques have been defined and successfully applied to correct shortness, curvature or various deformities due to penile deformity.
Penile Prosthesis:
Penile prostheses are applied in order to both fix the curvature and provide stiffness in patients with severe erectile dysfunction with Peyronie’s disease.
Is Peyronie’s surgery difficult?
It is incomparably easier with surgeries involving other vital organs (such as coronary bypass for the heart or brain surgeries). However, penile surgeries are one of the most important, specific, and serious surgeries that require experience and knowledge when evaluated on their own.
What are the risks of Peyronie’s disease surgery?
Although it depends on the type of surgery to be performed for Peyronie’s, there is a risk of bleeding and infection in the early period. Erectile dysfunction can sometimes be seen in surgeries where plaque excision is made and patch is applied instead.
Is Peyronie associated with erectile dysfunction?
This disease is seen with erection problems especially in advanced periods and in cases where curvature is evident. Curvature of the penis can be a challenge for sexual intercourse as well as erectile dysfunction.
Is penile prosthesis surgery performed in Peyronie’s disease?
If Peyronie’s disease is accompanied by erectile dysfunction, happiness stick surgery (penile prosthesis) can be applied when necessary. However, this does not apply to every patient. It is planned as a last option and in case of need in line with the recommendation of your doctor.
Is Peyronie’s disease surgery expensive?
In case of surgery for Peyronie’s disease, many factors such as the presence of curvature in the penis, the degree of curvature, the type of procedure to be performed, the probable duration of the operation, the characteristics of the hospital where the operation will be performed, and the experience of the surgeon, affect the price of the operation. Therefore, the price range is diverse.
How is penile curvature treated?
It is essential to plan your treatment with a person experienced in the disease. It is important to pay attention to your doctor’s recommendations. You have to be patient. Since it is not a disease that the problem will be completely eliminated by drinking a single box of medicine, your follow-up and treatment process should be planned appropriately.
Is surgery the definitive solution for penile curvature?
Curvatures can be corrected with surgery. However, there are other treatment methods to be applied until the surgery. If no results can be obtained after these treatments are applied, then the option of surgery comes to the fore.
After how many days does sexual intercourse start after Peyronie’s disease surgery?
Sexual intercourse is allowed approximately 4-6 weeks after the operation. However, this period may be longer depending on the condition of the disease.
Can Peyronie’s disease be treated with herbal medicine?
In terms of evidence-based medicine, there is no herbal treatment cure whose efficacy and safety have been confirmed and proven by clinical studies. However, even if it is assumed that some of the phytotherapeutics used can be good for the disease, this is not a proven data.
Is Peyronie’s disease congenital?
Peyronie’s disease is not a congenital disease. Although it is thought that it may be congenital because it causes curvature in the penis, this disease occurs later. However, there may be congenital penile curvatures, but the name of that disease is not Peyronie.
Does Peyronie’s disease go away on its own?
Although the exact mechanisms of Peyronie’s disease are not known, the treatment process cannot be predicted precisely either. Therefore, there is no clear consensus on how the disease will progress in which patient. There is a possibility of spontaneous recovery in some patients.
What difficulties does Peyronie’s disease cause during sexual intercourse?
Due to the disease, 3 difficulties are experienced during sexual intercourse:
- Erectile dysfunction and inability to have intercourse
- Penile curvature and related inability to have sexual intercourse
- Pain during erection and sexual intercourse
How many mg of vitamin E dose is used in case of penile curvature?
For this disease, it is often enough to use a daily dose of 200-400 mg.
Is Peyronie’s disease permanent?
No. There are cases where successful resolution has been achieved with treatment. However, it is mistakenly considered as a permanent disease because of the long treatment process and permanent penile curvature disease in some patients.
Which hospitals are in Ankara that perform Peyronie’s surgery?
Peyronie’s surgeries are successfully treated in many public and private health institutions in Ankara.
Is there an age limit for Peyronie’s surgery?
There is no specific age limit for Peyronie’s surgery. It can be applied to patients of all ages who are sexually active. If the happiness stick (penile prosthesis) is to be used in elderly patients with concomitant erection problems, dexterity is required.
Can Peyronie ESWT be treated with shock waves?
ESWT shock waves have been increasingly used in urology in recent years. It is aimed to increase the formation of new vascularity and to regenerate and repair the penile tissue with regeneration. Although there are studies reporting that it is beneficial for Peyronie’s disease, it is an area where more clinical studies are needed.
Can Peyronie be treated with vitamin E?
Vitamin E has long been used in the treatment of Peyronie’s disease. Although its effect has been controversial in recent years, it has been a common treatment for many years. According to the latest scientific data of the European Association of Urology, the use of vitamin E is not recommended.
Can Peyronie be treated with radiation therapy?
If what is meant by radiation therapy is Radiotherapy, No! What is meant by radiation therapy is ESWT, than yes. Shock waves have been used in recent years.
Does penile curvature progress or is it a progressive disease?
The progressive feature of the disease depends on the patient, the person’s body, the immune system, the accompanying systemic diseases and the drugs used in their treatment, and the duration of exposure to the disease. Therefore, although it is progressive in some patients, improvement can be achieved with treatment in others.
What is meant by needle therapy in Peyronie’s?
Needle therapy mostly refers to injections into the plaque. Its purpose is to melt and disintegrate hard plaques with the help of some drugs.
Does Peyronie have an hourglass deformity?
We have previously stated that penile curvatures can be seen in Peyronie’s disease. A deformity called “hourglass deformity” can cause penile curvature, since the plates holding the middle of the penis thin out in this region.
Does Peyronie’s disease shorten the length of the penis?
In Peyronie’s disease, which progresses with advanced plaque formation, both shortening of the penis length and penile erection problem may occur.
Does Peyronie cause cancer?
No relationship was found between Peyronie’s disease and penile cancer.
Is there any cream for Peyronie?
Although some creams with anti-inflammatory effects are used in the early stages of the disease, their obvious benefits are controversial.
Does Peyronie’s plaque increase?
As the triggering and initiating factor stands, plaque progression may occur. Many factors such as the patient’s age, systemic diseases, drugs used, and immune system resistance are determinative in this. However, an increase in plaque size is not expected in every patient.
How is Peyronie’s plaque treated?
Plaques are palpable hardness in the penis. First of all, medical treatments are tried. In cases where there is no response, non-surgical solutions are used. If there is no result from these, the plaques are removed with the surgical method.
What is Peyronie’s plaque excision?
It means the removal of plaques that cause stiffness in the penis by surgical methods.
Can Peyronie’s disease be treated with leech therapy?
There is no evidence that the disease can be cured by leeches. On the contrary, these applications to the penis can cause serious side effects such as irritation, redness and infection in the penis. Therefore, it is not recommended.
Will the healing process be shortened after Peyronie’s causes are eliminated?
It is difficult to pinpoint the causes of Peyronie’s. However, if the causative factor is clearly known, it can be expected that the recovery period of the disease will be accelerated and shortened by eliminating it.
What is shock wave therapy “ESWT” in Peyronie’s disease?
Shock wave therapy “ESWT” provides tissue regeneration, repair and improvement in tissues by increasing new vessel formation. It is thought that similar healing effects may also occur in the penis in Peyronie’s disease.
Do you do the Peyronie treatment in Ankara?
Peyronie treatment is planned in our clinic in Kale Ofis Plaza in Çukurambar, Ankara.
Is ultrasound used in the diagnosis of Peyronie’s?
Penile ultrasonography and penile color Doppler ultrasonography are used to determine the localization, diameter and length of the plaque formed when needed, or to reveal the vascular pathologies of the existing erection problem.
Is there consensus among Peyronie’s specialists for the timing of surgery?
The generally accepted view is that a surgical treatment should not be planned for patients at least 1 year after the onset of the disease.
How are the Peyronie treatment fees in urology compared to other surgeries?
It is in parallel price ranges with other surgery fees without requiring an extra cost.
Is there a risk of vitamin E treatment in Peyronie’s?
Vitamin E is a fat-soluble vitamin. Long-term use may cause problems associated with it. Apart from this, no health risks have been reported regarding their short-term use.
What should be considered when using Peyronie’s medical therapy drugs?
Due to the toxic effects that may occur on the liver during the use of drugs such as colchicine and POT**B*A, attention should be paid to stomach problems, kidney functions and bleeding diathesis during the use of nonsteroidal anti-inflammatory drugs. Long-term use must be done under the supervision of a doctor. Patients should definitely not start this group of drug treatments themselves.
What are the disadvantages of Peyronie’s disease?
Functional damages:
It causes functional disorders such as inability to have sexual intercourse due to curvature of the penis, difficulty during sexual intercourse and inability to maintain intercourse, pain during sexual intercourse and impaired erection.
Aesthetic damages:
It can occur in the penis at different degrees at different angles to the right, left, up or down, and sometimes it occurs in the midline of the penis, causing an hourglass deformity and causing aesthetic disorders in the penis.
Psychological harm:
Both aesthetic and functional results negatively affect the psychological structure of the individual. Sometimes this negative interaction is reflected on the partner of the individual and negative effects occur between the spouses due to Peyronie’s disease.
CAUTION in Peyronie’s disease!!! What are the issues to be considered?
- Early diagnosis and treatment are important.
- In case of clinical doubt, consult a doctor.
- Keep in mind that the disease may heal, but it will take time.
- If you can identify the triggering or sustaining factor related to the disease, moving away will make your disease heal in a shorter time.
- Be aware of the effects and side effects of the drugs that your doctor will prescribe, and do not neglect the control in the period recommended by your doctor in terms of follow-up.
- It is important that you know the rough onset time of your illness. Because it is generally accepted for the treatment of this disease not to rush for surgery and to wait for roughly one year to pass since this onset time.
CONCLUSION:
- Peyronie’s disease is an important disease that causes penile pain and penile curvature.
- Pain and penile curvature may be at a level that may interfere with sexual intercourse.
- Peyronie’s plaques occur due to structural disorders in the penis.
- Peyronie’s plaques should also be considered for palpable penile stiffness.
- It can be treated with drugs, non-drug methods and surgeries.
- There is a need for more clinical studies with new drugs and different options that are injected into the penis.