Peyronie's disease is a condition characterized by a hard lump, or plaque, that forms within the penis. Symptoms of Peyronie's disease range from mild to severe. Treatment for Peyronie's disease includes medication, and often surgery.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
Peyronie's disease is the development of plaques or scar tissue inside the penis that cause penis curvature and painful erections.
Symptoms range from mild to severe painful erections and difficultly or inability to have sexual intercourse.
The disease may develop either quickly or slowly; the cause is the plaque formation that researchers speculate occurs after penile trauma, chronic inflammation or autoimmunity.
Peyronie's disease is evaluated by physical exam of palpating plaque in the penis, by examination of the erection and by
Medical treatment of the disease is empirical; sometimes the disease symptoms will spontaneously reduce but most medical treatments have not been proven to be effective although research is ongoing.
Surgical treatments (plaque removal, plication or device implantation) have had some success but may involve other complications; medical experts advise waiting one year or more before having surgery.
What is Peyronie's disease?
Peyronie's disease is characterized by a plaque, or hard lump, that forms within the penis. The plaque, a flat plate of scar tissue, develops on the top or bottom side of the penis inside a thick membrane called the tunica albuginea, which envelopes the erectile tissues. The plaque begins as a localized inflammation and develops into a hardened scar. This plaque has no relationship to the plaque that can develop in arteries.
Cases of Peyronie's disease range from mild to severe. Symptoms may develop slowly or appear overnight. In severe cases, the hardened plaque reduces flexibility, causing pain and forcing the penis to bend or arc during erection. In many cases, the pain decreases over time, but the bend in the penis may remain a problem, making sexual intercourse difficult. The
sexual problems that result can disrupt a couple's physical and emotional relationship and can lower a man's self-esteem. In a small percentage of men with the milder form of the disease, inflammation may resolve without causing significant pain or permanent bending.
The plaque itself is benign, or noncancerous. It is not a tumor. Peyronie's disease is not contagious and is not known to be caused by any transmittable disease.
A plaque on the topside of the shaft, which is most common, causes the penis to bend upward; a plaque on the underside causes it to bend downward. In some cases, the plaque develops on both top and bottom, leading to indentation and shortening of the penis. At times, pain, bending, and emotional distress prohibit sexual intercourse.
A cross-section of the penis (left) displays the internal cavity that runs the length of the penis and is divided into two chambers-corpora cavernosa-by a vertical connecting tissue known as a septum. Scientists theorize that, during trauma such as bending, bleeding might occur at a point of attachment of the septum to the tunica albuginea lining the chamber wall (center). The bleeding results in a hard scar, or plaque, which is characteristic of Peyronie's disease. The plaque reduces flexibility on one side of the penis during erection, leading to curvature (right).
Estimates of the prevalence of Peyronie's disease range from less than 1 percent to 23 percent.¹ A recent study in Germany found Peyronie's disease in 3.2 percent of men between 30 and 80 years of age.² Although the disease occurs mostly in middle age, younger and older men can develop it. About 30 percent of men with Peyronie's disease develop hardened tissue on other parts of the body, such as the hand or foot. A common example is a condition known as Dupuytren's contracture of the hand. In some cases, Peyronie's disease runs in families, which suggests that genetic factors might make a man vulnerable to the disease.
A French surgeon, Francois de la Peyronie, first described Peyronie's disease in 1743. The problem was noted in print as early as 1687. Early writers classified it as a form of impotence, now called erectile dysfunction (ED). Peyronie's disease can be associated with ED-the inability to achieve or sustain an erection firm enough for intercourse.
However, experts now recognize ED as only one factor associated with the disease-a factor that is not always present.
Reviewed by Jerry R. Balentine, DO, FACEP on 3/23/2012