Peyronie’s Disease
Peyronie’s disease is a penile disorder in which scar tissue or plaque forms in the lining of the penis, making it less flexible. This can cause the penis to bend or curve when erected (penile curvature), which can be painful and make intercourse difficult or even impossible. In severe cases, this pain, bending, and associated emotional distress can cause impotence. Peyronie's disease occurs in about 1% of men and is most common in middle-age.
Peyronie’s Disease Symptoms
During the first 12 months, you may experience:
- Hardened lump (plaque) in the penis
- Pain during erection
- Curve in the penis during erection
- Distortion of the penis (indentation, shortening)
Erectile dysfunction is common in patients with Peyronie’s disease.
Causes of Peyronie’s Disease
Peyronie’s disease typically forms from trauma occurring during sexual intercourse, athletic activities, or other types of accidents. The injury may be minor, but it can lead to inflammation and a penile scar or lump.
Peyronie’s Disease Diagnosis
A urologist will check your medical and surgical history and examine your penis for hardened tissue. A curve assessment may be necessary to measure the degree of penile curvature with an erect penis. To do this, a substance that relaxes the blood vessels is injected into the penis, causing an erection.
Dynamic ultrasound may also be needed to examine the location of the plaque and blood flow to the penis and check for calcium build-up.
From the diagnosis, two phases of the disease can be distinguished:
- In the acute inflammatory phase, the plaques are forming in the penis, and the bending of the penis is getting worse. Men will feel pain in the flaccid state or experience painful erections. This phase typically lasts between 6 and 18 months.
- In the stable phase, the plaque has stopped growing, and the curvature of the penis has stopped progressing. The pain usually subsides.
Peyronie’s Disease Treatment Options
In its mild form, Peyronie's disease can improve without surgery in 6 to 18 months, with the shrinking and disappearance of the scar tissue. During this waiting time, there are a few options that might improve symptoms. They include:
- Oral medications: Vitamin E and B-Complex tablets.
- Chemical agents injected directly into the scar tissue of the penis to break it down.
- Shock Wave therapy, where high-energy rays are directed to the scar tissue or plague to break it down, inducing blood flow to the area. LI-ESWT (Low Intensity-Extracorporeal Shock Wave Therapy) is a new and painless treatment that has been quite effective in helping manage Peyronie's disease for refractory penile pain, plaque size reduction, and improving erectile dysfunction
After 12 to 18 months, if the condition is still affecting the patient’s quality of life or in more serious cases, your urologist may recommend surgery. The types of surgeries include:
- Penile plication: A minimally invasive surgery that involves straightening the penis by “cinching” the penis on the side opposite the curve.
- Plaque excision and grafting: A surgical procedure that straightens the penis by removing the plaque and replacing it with a more pliable grafted material. This procedure is useful for severe curves or deformities.
- Penile prosthesis: A surgical procedure involving the placement of cylinders/implants into your penis (allowing it to straighten), a pump in your scrotum, and a reservoir of fluid in your abdomen.
Why should you choose Dr Colin Teo to perform Peyronie’s Disease treatments?
Dr Colin Teo is the Founding Head of Khoo Teck Puat Hospital’s Urology Department, with years of experience in minimally invasive keyhole surgery, operating with precision surgical techniques. Many fellows have trained under his mentorship. He did a Fellowship in EndoLaparoscopy and Andrology at St James’ Hospital in Leeds, UK and was sponsored for a Senior Healthcare Medical Development Program (HMDP) in Advanced Laparoscopic and Robotic Surgery at University of Southern California (USC) Keck Hospital in Los Angeles, USA. Dr Teo is also the President of the Society for Men’s Health.
Seek recommendations on suitable treatment options for Peyronie’s Disease with Colin Teo Urology. Contact us to book an appointment today.
