What are the first signs and symptoms of Peyronie’s Disease?
You will probably notice pain in your penis when it is erect. Over the space of a few months you would begin to see that the penis bends when erect, and when it is flaccid, you might be able to feel a lump under the skin. The lump under the skin—called a ‘plaque’—prevents the tissue of the penis from expanding as it should, and this makes the penis bend when erect.
Who is at risk of the disease and how can I decrease the risk of developing Peyronie’s Disease?
Typically it is men in their 40’s and 50’s who first develop the condition, although there are a few cases on record in very young men, especially if they are diabetic. It is not known what causes Peyronie’s to develop, and apart from the usual advice to not smoke and to generally care of your health, there is no specific way of preventing it.
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I have just been diagnosed with Peyronie’s Disease, what are the first steps I need to take?
Over the first six to eighteen months there is little that can be done until the condition settles down. Your doctor might prescribe vitamin E creams or tablets. There is some interest in the use of vacuum pumps and other physical devices that might help to prevent the bending from getting worse. However, there is no good scientific evidence to support these treatments. As Peyronie’s gets worse, it often affects the mental health of both the patient and his life partner. It is important to be prepared for this, and perhaps for both of you to arrange for counselling or to consider anxiety medication as part of the treatment for Peyronie’s disease.
What causes Peyronie’s Disease?
The cause is unknown. One widely believed theory is that ordinary sexual intercourse can cause what is known as “micro-trauma” inside the penis. This “micro-trauma” cannot be felt, or seen, because it causes no pain and leaves no bruising. When this microscopic injury heals, scar tissue in the form of a collagen plaque is deposited in certain susceptible men. Peyronie’s disease occurs more often in people who get these collagen plaques in other sites in the body as well. There are related conditions, these are called Dupuytren’s and Ledderhose; Dupuytren’s is the contracture that occurs in the hands and Ledderhose disease resides in the feet.
Is Peyronie’s Disease a lifelong condition and what advice can you give for someone living with the disease?
Peyronie’s disease cannot be fully ‘cured’ at present however there are options of treatment for Peyronie’s disease. These options are available once the condition has passed beyond the active stage (usually about twelve months). Treatments can work and in most cases will straighten the penis so that you can have penetrative sex again. Try to be patient for the first few months, get it checked out to make sure that the lump is not cancerous, it’s best to discuss the options with your consultant.
How would I know the difference between Peyronie’s Disease, Congenital Curvature or benign bumps?
Congenital curvature is sometimes called ‘chordee’, it has a different cause to Peyronie’s disease. With Chordee, the penis hasn’t developed properly from when the baby was in the womb and this causes it to bend when erect. Chordee is not due to a plaque of collagen. It would not develop gradually over time: the man would notice from an early age that his penis was always bent when erect. Benign bumps within the penis are rare compared with warts or spots on the surface caused by viruses—any lumps or bumps should always be referred to a doctor immediately.
What are the different phases of Peyronie’s Disease?
There are two phases in Peyonrie’s disease—the acute (active) phase and the chronic (stable) phase. The active phase usually lasts from six to eighteen months. During this time erections will be uncomfortable or painful and the erect penis will gradually become more bent as the condition worsens. Usually, after about one year, the condition stabilises. During this stable phase the pain subsides, but the patient is left with a penis that is always bent when erect.
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What are the treatment options for Peyronie’s Disease?
There are a few avenues of treatment for Peyronie’s disease that can be explored; it can be treated by surgery, which is effective at straightening the penis, but will always result in some loss of length. On rare occasions patients can get complications from surgery such as infections, loss of feeling, or impotence. Recently a treatment for Peyronie’s disease has been licensed where the collagen plaque is injected with an enzyme that softens the collagen. The patient then does some physio on their penis at home every day. The injection can be repeated up to eight times. While it does not shorten the penis, there have been a few reports of side effects requiring surgery to correct them; all patients will get some local reaction to the injections. After treatment the patient will have a ‘functionally straight’ penis (that might not be as straight as being treated by a surgical procedure) but will allow the resumption of normal sexual relations.
What are the risks if Peyronie’s Disease is not treated early or at all?
Early surgical or injection treatment is not useful until the bend in the penis has become stable. If no treatment for Peyronie’s disease is administered, it will not get better on its own, the male would be left with a penis that is always bent when erect. Sometimes the bend can be extreme: more than 100 degrees of bend, this would certainly prevent penetrative sex. However, there are no life-threatening implications of Peyronie’s disease.
Will having Peyronie’s Disease affect my intimate relationships?
Untreated Peyronie’s disease can severely affect intimate relationships but it all depends on how severe the bend in the penis is. Bends less than 30 degrees might not need treatment. Bends more severe than this would make penetrative sex very difficult and this would obviously affect the nature of a typical intimate relationship. Fortunately, there are some good treatments for Peyronie’s disease, and there is no reason for a man or his partner to suffer in silence.
Swedish Orphan Biovitrum are an international specialty healthcare company, dedicated to rare diseases. To find out more about them, visit their website: sobi.com
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