PEYRONIE’S DISEASE

ICD-9: 607.85

What is Peyronie’s Disease?

Peyronie’s Disease is an

acquired inflammatory

condition where the development

of fibrous scar tissue inside the

penis causes curved, painful

erections.

The name “Peyronie’s Disease” is derived from the physician Francois

Gigot de la Peyronie, the personal physician to

King Louis XV of France. De la Peyronie wrote an authoritative description of the disorder in 1743.

His name has been associated with the

condition since.

What causes Peyronie’s?

The exact cause of Peyronie’s Disease is unclear. Many researchers believe the plaque of Peyronie’s Disease can develop following trauma (hitting or bending) that causes localized bleeding inside the penis with tissue damage. In other cases, the disease may be genetically linked or inherited. Other suggested causes include vasculitis-an inflammation of blood or lymphatic vessels that leads to scar tissue formation, and a possible autoimmune disorder.

Symptoms of Peyronie’s

Symptoms may develop slowly or appear overnight. When the penis is soft, no

problem can be seen.

Symptoms (continued)

A bend in the erect penis Narrowing of the penis with erection Shortening of the penis Lumps in the penis Painful erections Pain during intercourse Soft erections Difficulty achieving or maintaining an

erection Difficult penetration due to curvature of the

penis

Diagnosis

Physical Examination-an experienced physician can feel the hardened tissue. The hard plaques can usually be felt with or without an erect penis though it may be necessary to induce an erection.

Procedures-ultrasound or x-ray examination can be used to detect and characterize plaque and any calcification.

Treatment

Treatment of Peyronie’s Disease depends on the duration and severity of the condition. The goals of treatment are to relieve pain, restore penile anatomy for comfortable intercourse, and restore any lost erectile function. In about 13% of cases, the disease goes away without treatment. No treatment is required if:

• There is no pain• Plaques are small• The curvature is minor• Sexual function is satisfactory

Treatment (continued)

Oral Medications:• Vitamin E• Potassium amino-benzoate• Tamoxifen• Cholchicine• Carnitine• Verapamil• Interferon alpha-2b

Treatment (continued)

Surgery- is reserved for men with severe, disabling penile deformities that prevent satisfactory sexual intercourse.

• Shortening the unaffected side: The Nesbit procedure removes the tunica on the affected side to correct the bending.

• Lengthening of the affected side: The scar tissue may be cut or removed to allow the tunica albuginea to stretch and the penis to straighten.

• Penile implants: to replace the corpora cavernosa the semi-rigid implants are bent up manually for intercourse and bent down to appear flacid.

Treatment (continued)

Non-surgical treatments for Peyronie’s disease include:

• External penile traction therapy, to improve girth, length, and curvature.

• Radiation therapy, to reduce pain.

• Shock wave lithotripsy, which can break up plaque.

References

Kaplan Quad/The Gale Encyclopedia of Medicine/Peyronie’s Disease

WedMD/Erectile Dysfunction Health Center/Peyronie’s Disease

UrologyHealth.org/Urology Care Foundation/Peyronie’s Disease

Mayo Clinic.com/Diseases and conditions/Peyronie’s Disease